No office rate
Choose 90945 for a non-hemodialysis dialysis service with one evaluation. Repeated evaluations during that service point to 90947.
On this page
CMS RVU26D · Effective 2026-10-01
90947 Dialysis evaluation Medicare reimbursement rates in Alabama
Report this service when a physician or qualified health care professional repeatedly evaluates a patient during dialysis other than hemodialysis, such as peritoneal dialysis or continuous renal replacement therapy. Compare 90947 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 90947 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$101.45
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Dialysis services
About 90947: Repeated evaluation during non-hemodialysis dialysis
Report this service when a physician or qualified health care professional repeatedly evaluates a patient during dialysis other than hemodialysis, such as peritoneal dialysis or continuous renal replacement therapy.
This service covers repeated clinical evaluations during a dialysis procedure that is not hemodialysis. Examples include peritoneal dialysis and continuous renal replacement therapy. A nephrologist or another qualified health care professional may assess the patient’s response, review treatment parameters, and adjust the dialysis prescription in a hospital or other dialysis setting. The repeated evaluations distinguish this service from the corresponding non-hemodialysis service involving a single evaluation.
Report 90947 for the dialysis service when documentation supports multiple evaluations during treatment; it is not a separate charge for each check. Record the dialysis modality, the evaluations performed, the patient’s response, and any prescription changes. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for this service. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 90947
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.46 · 77%
- Practice expense (office) RVU0.55 · 17%
- Malpractice RVU0.17 · 5%
8.8K
Medicare services in 2024 · #1545 by national volume
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.
90947 compared with similar codes
Office rates for Alabama, from the same CMS release.
No office rate
Both represent repeated evaluations, but 90937 applies to hemodialysis; 90947 applies to dialysis procedures other than hemodialysis.
No office rate
90935 is for a single evaluation during hemodialysis. It differs from 90947 in both dialysis modality and evaluation pattern.
Compare 90947 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
Unavailable
Facility
$101.45
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 90947 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
11,563
- Code
- 90947
- Physician work
- 2.46
- Practice expense
- 0.55
- Malpractice
- 0.17
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.46 | × 1.000 | 2.4600 |
| Practice expense | 0.55 | × 0.875 | 0.4813 |
| Malpractice | 0.17 | × 0.566 | 0.0962 |
| Total RVUs | 3.0375 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alabama$101.45
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.46 | 1 |
| Practice expense | 0.55 | 0.875 |
| Malpractice | 0.17 | 0.566 |
(2.46 × 1 + 0.55 × 0.875 + 0.17 × 0.566) × $33.4009 = $101.45
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
90947 billing questions
How does 90947 differ from 90945?
Both describe dialysis other than hemodialysis. Use 90947 when the service includes repeated evaluations; 90945 represents a single evaluation.
Can each evaluation be billed as a separate unit?
No. Repeated evaluations are part of the service represented by 90947, not separate units for each assessment.
How does 90947 differ from 90937?
Both involve repeated evaluations, but 90947 is for dialysis other than hemodialysis, while 90937 is for hemodialysis.
What documentation supports reporting 90947?
Document the dialysis modality, repeated evaluations during the treatment, findings about the patient’s response, and any resulting changes to the dialysis prescription.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for 90947; the service is not reported for paired body sides.
Can an assistant, co-surgeon, or surgical team be paid?
Assistant-at-surgery payment requires documented medical necessity. CMS does not permit co-surgeons or team surgery for this code.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
11,56090937,,Hemodialysis repeated eval,A,,2.06,0.46,NA,0.46,,0.13,2.65,2.65,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56190940,,Hemodialysis access study,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56290945,,Dialysis one evaluation,A,,1.52,0.70,NA,0.70,,0.09,2.31,2.31,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56390947,,Dialysis repeated eval,A,,2.46,0.55,NA,0.55,,0.17,3.18,3.18,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56490951,,Esrd serv 4 visits p mo <2yr,A,,23.92,10.06,,10.06,,1.46,35.44,35.44,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56590952,,Esrd serv 2-3 vsts p mo <2yr,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,56690953,,Esrd serv 1 visit p mo <2yrs,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515