No office rate
90945 describes dialysis other than hemodialysis with a single physician evaluation. Choose 90997 when the performed treatment is hemoperfusion using an adsorbent cartridge.
On this page
CMS RVU26D · Effective 2026-10-01
90997 Hemoperfusion Medicare reimbursement rates in Kentucky
Report hemoperfusion for a treatment that circulates blood through an adsorbent cartridge to remove selected drugs or toxins. Compare 90997 office and facility rates across CMS payment localities in Kentucky.
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 90997 in Kentucky?
Kentucky 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
$74.43
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 90997: Physician hemoperfusion treatment
Report hemoperfusion for a treatment that circulates blood through an adsorbent cartridge to remove selected drugs or toxins.
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.
CMS billing rules for 90997
- 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 RVU1.79 · 79%
- Practice expense (office) RVU0.38 · 17%
- Malpractice RVU0.11 · 5%
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.
90997 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
90947 is for other dialysis with repeated physician evaluation during the procedure. It is not the code for a hemoperfusion treatment.
No office rate
90935 is for hemodialysis with a single physician evaluation. Hemoperfusion uses an adsorbent cartridge rather than the hemodialysis method.
90999
No office rateUnlisted dialysis procedure
90999 is the unlisted dialysis procedure code. Use the specific hemoperfusion code when the service performed is hemoperfusion.
Compare 90997 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$74.43
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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 90997 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
11,586
- Code
- 90997
- Physician work
- 1.79
- Practice expense
- 0.38
- Malpractice
- 0.11
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.79 | × 1.000 | 1.7900 |
| Practice expense | 0.38 | × 0.889 | 0.3378 |
| Malpractice | 0.11 | × 0.915 | 0.1007 |
| Total RVUs | 2.2285 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$74.43
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.79 | 1 |
| Practice expense | 0.38 | 0.889 |
| Malpractice | 0.11 | 0.915 |
(1.79 × 1 + 0.38 × 0.889 + 0.11 × 0.915) × $33.4009 = $74.43
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.
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 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.
11,58390970,,Esrd svc pr day pt 20+,A,,0.18,0.11,,0.11,,0.01,0.30,0.30,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,58490989,,Dialysis training complete,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
11,58590993,,Dialysis training incompl,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
11,58690997,,Hemoperfusion,A,,1.79,0.38,NA,0.38,,0.11,2.28,2.28,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,58790999,,Unlisted dialysis procedure,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
11,58891010,,Esophagus motility study,A,,1.25,6.02,,6.02,NA,0.09,7.36,7.36,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,58991010,26,Esophagus motility study,A,,1.25,0.71,,0.71,,0.07,2.03,2.03,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631