CPT 90960: what Medicare pays in 2026
Dialysis
Medicare's 2026 national amount for 90960 is $372.75 when a doctor's office or clinic bills it and $372.75 when a doctor bills it for care in a hospital, ER or surgery center. Across Medicare's 109 payment localities the office amount runs from $347.14 in Arkansas to $487.96 in Alaska.
CPT descriptions are copyrighted by the American Medical Association, so this page shows the code number only. The description printed on your bill, or the provider, will tell you what the code covers.
Medicare amounts for 90960 in 2026
- Doctor's office or clinic, national
- $372.75
- Doctor's bill for hospital or surgery-center care, national
- $372.75
- Hospital outpatient status M
- not billable by hospitals
What providers charged Medicare for 90960 in 2024
From CMS's national utilization file (the most recent full year published). The charge is the provider's list price, the same kind of figure an uninsured patient is usually billed.
| Setting | Services | Average charge | Medicare allowed | Charge vs allowed |
|---|---|---|---|---|
| In an office or other non-facility setting | 1,096,923 | $769.66 | $347.44 | 2.2× |
| In a facility setting | 27,830 | $912.71 | $352.87 | 2.6× |
How Medicare builds the 90960 amount
Each physician fee schedule amount is three relative value units (RVUs), each multiplied by the locality's cost index, added up and multiplied by the 2026 conversion factor of $33.4009.
- Work RVU
- 6.77
- Practice expense RVU, office
- 3.96
- Practice expense RVU, facility
- 3.96
- Malpractice RVU
- 0.43
90960 in every Medicare locality
The office amount is lowest in Arkansas and highest in Alaska. The facility amount runs from $347.14 to $487.96.
| State | Locality | Office | Facility |
|---|---|---|---|
| AK | Alaska | $487.96 | $487.96 |
| AL | Alabama | $349.99 | $349.99 |
| AR | Arkansas | $347.14 | $347.14 |
| AZ | Arizona | $366.59 | $366.59 |
| CA | Bakersfield | $384.13 | $384.13 |
| CA | Chico | $382.63 | $382.63 |
| CA | El Centro | $382.70 | $382.70 |
| CA | Fresno | $382.63 | $382.63 |
| CA | Hanford-Corcoran | $382.63 | $382.63 |
| CA | Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County) | $401.40 | $401.40 |
| CA | Madera | $382.63 | $382.63 |
| CA | Merced | $382.63 | $382.63 |
| CA | Modesto | $382.63 | $382.63 |
| CA | Napa | $421.99 | $421.99 |
| CA | Oxnard-Thousand Oaks-Ventura | $397.74 | $397.74 |
| CA | Redding | $382.63 | $382.63 |
| CA | Rest of California | $382.63 | $382.63 |
| CA | Riverside-San Bernardino-Ontario | $387.41 | $387.41 |
| CA | Sacramento-Roseville-Folsom | $395.79 | $395.79 |
| CA | Salinas | $394.13 | $394.13 |
| CA | San Diego-Chula Vista-Carlsbad | $398.88 | $398.88 |
| CA | San Francisco-Oakland-Berkeley (Marin County) | $440.70 | $440.70 |
| CA | San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County) | $440.21 | $440.21 |
| CA | San Jose-Sunnyvale-Santa Clara (San Benito County) | $449.43 | $449.43 |
| CA | San Jose-Sunnyvale-Santa Clara (Santa Clara County) | $447.43 | $447.43 |
| CA | San Luis Obispo-Paso Robles | $388.32 | $388.32 |
| CA | Santa Cruz-Watsonville | $399.28 | $399.28 |
| CA | Santa Maria-Santa Barbara | $394.38 | $394.38 |
| CA | Santa Rosa-Petaluma | $403.03 | $403.03 |
| CA | Stockton | $382.63 | $382.63 |
| CA | Vallejo | $421.29 | $421.29 |
| CA | Visalia | $382.63 | $382.63 |
| CA | Yuba City | $382.63 | $382.63 |
| CO | Colorado | $380.79 | $380.79 |
| CT | Connecticut | $390.48 | $390.48 |
| DC | DC + MD/VA Suburbs | $410.13 | $410.13 |
| DE | Delaware | $370.85 | $370.85 |
| FL | Fort Lauderdale | $386.08 | $386.08 |
| FL | Miami | $400.14 | $400.14 |
| FL | Rest of Florida | $374.16 | $374.16 |
| GA | Atlanta | $378.44 | $378.44 |
| GA | Rest of Georgia | $361.23 | $361.23 |
| HI | Hawaii, Guam | $384.83 | $384.83 |
| IA | Iowa | $352.85 | $352.85 |
| ID | Idaho | $354.60 | $354.60 |
| IL | Chicago | $393.60 | $393.60 |
| IL | East St. Louis | $376.74 | $376.74 |
| IL | Rest of Illinois | $369.33 | $369.33 |
| IL | Suburban Chicago | $389.00 | $389.00 |
| IN | Indiana | $355.72 | $355.72 |
| KS | Kansas | $352.93 | $352.93 |
| KY | Kentucky | $356.85 | $356.85 |
| LA | New Orleans | $366.90 | $366.90 |
| LA | Rest of Louisiana | $356.94 | $356.94 |
| MA | Metropolitan Boston | $406.11 | $406.11 |
| MA | Rest of Massachusetts | $380.47 | $380.47 |
| MD | Baltimore/Surrounding Counties | $389.43 | $389.43 |
| MD | Rest of Maryland | $375.42 | $375.42 |
| ME | Rest of Maine | $356.74 | $356.74 |
| ME | Southern Maine | $366.26 | $366.26 |
| MI | Detroit | $377.98 | $377.98 |
| MI | Rest of Michigan | $363.10 | $363.10 |
| MN | Minnesota | $366.48 | $366.48 |
| MO | Metropolitan Kansas City | $364.36 | $364.36 |
| MO | Metropolitan St. Louis | $366.43 | $366.43 |
| MO | Rest of Missouri | $354.13 | $354.13 |
| MS | Mississippi | $350.62 | $350.62 |
| MT | Montana | $372.73 | $372.73 |
| NC | North Carolina | $358.71 | $358.71 |
| ND | North Dakota | $364.22 | $364.22 |
| NE | Nebraska | $353.64 | $353.64 |
| NH | New Hampshire | $376.38 | $376.38 |
| NJ | Northern NJ | $409.14 | $409.14 |
| NJ | Rest of New Jersey | $395.36 | $395.36 |
| NM | New Mexico | $364.66 | $364.66 |
| NV | Nevada | $370.49 | $370.49 |
| NY | Manhattan | $417.07 | $417.07 |
| NY | NYC Suburbs/Long Island | $424.53 | $424.53 |
| NY | Poughkeepsie/Northern NYC Suburbs | $398.51 | $398.51 |
| NY | Queens | $417.65 | $417.65 |
| NY | Rest of New York | $361.88 | $361.88 |
| OH | Ohio | $361.36 | $361.36 |
| OK | Oklahoma | $355.40 | $355.40 |
| OR | Portland | $387.38 | $387.38 |
| OR | Rest of Oregon | $367.96 | $367.96 |
| PA | Metropolitan Philadelphia | $385.02 | $385.02 |
| PA | Rest of Pennsylvania | $361.12 | $361.12 |
| PR | Puerto Rico | $373.99 | $373.99 |
| RI | Rhode Island | $379.86 | $379.86 |
| SC | South Carolina | $360.55 | $360.55 |
| SD | South Dakota | $363.22 | $363.22 |
| TN | Tennessee | $354.07 | $354.07 |
| TX | Austin | $379.24 | $379.24 |
| TX | Beaumont | $359.83 | $359.83 |
| TX | Brazoria | $370.21 | $370.21 |
| TX | Dallas | $372.22 | $372.22 |
| TX | Fort Worth | $371.08 | $371.08 |
| TX | Galveston | $371.17 | $371.17 |
| TX | Houston | $379.04 | $379.04 |
| TX | Rest of Texas | $364.62 | $364.62 |
| UT | Utah | $363.35 | $363.35 |
| VA | Virginia | $366.28 | $366.28 |
| VI | Virgin Islands | $373.99 | $373.99 |
| VT | Vermont | $364.34 | $364.34 |
| WA | Rest of Washington | $379.27 | $379.27 |
| WA | Seattle (King County) | $411.46 | $411.46 |
| WI | Wisconsin | $357.26 | $357.26 |
| WV | West Virginia | $361.62 | $361.62 |
| WY | Wyoming | $369.02 | $369.02 |