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See a sample rate comparisonCPT 90937 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Hemodialysis Procedure Requiri, Hemodialysis Procedure Requiring Repeated Evaluation(S) Withor Without Substantial Revision Of Dialysis Prescription Hemodialysis Procedure Requiringrepeated Evaluation(S) With
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Dialysis Services and Procedures |
| Common Place of Service | 21 - Inpatient Hospital 99 - Other POS |
| Common Modifiers | G5 - Most recent URR reading of 75 or greater V7 - Arteriovenous fistula |
| Complexity Level | Low |
| Medicare Fee Schedule | $88.51 national non-facility rate (2026) · View Medicare rates for 90937 |
| Medicaid Fee Schedule | $82.73 median of the 8 states in the free preview · View Medicaid rates for 90937 |
National average reimbursement for CPT 90937 by major payers:
$139.03
$137.75
$136.42
$167.82
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CPT 90937
5 of 25 sample ratesHigher to lower in this preview
Lauren Schumacher
$654.55Published rateMatthew Niedzwiecki
$209.41Published rateAmirreza Fallahi
Riverside Health System
$183.52Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$137.84Published rateChristopher Drew
Town Center Orthopaedic Associates, P.C.
$95.01Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 90937 vs. Other Dialysis Services and Procedures Codes
The CPT 90937 code is part of the Medicine Services and Procedures services used for Dialysis Services and Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 90937 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 90935-CPT | Low | Hemodialysis Procedure With Si, Hemodialysis Procedure With Single Physician Evaluationhemodialysis Procedure With Single Physician Evaluation |
| 90937-CPT | Low | Hemodialysis Procedure Requiri, Hemodialysis Procedure Requiring Repeated Evaluation(S) Withor Without Substantial Revision Of Dialysis Prescription Hemodialysis Procedure Requiringrepeated Evaluation(S) With |
| 90940-CPT | Low | Hemodialysis Access Flow Study, Hemodialysis Access Flow Study To Determine Blood Flow In Grafts And Arteriovenous Fistulae By An Indicator Dilution Method Hook-Up Measurement And Disconnection. |
| 90945-CPT | Low | Dialysis One Evaluation, Dialysis Procedure Other Than Hemodialysis Eg Peritoneal Dialysis Hemofiltration Or Other Continuous Renal Replacement Therapies With Single Evaluation By A Physician Or Other Qualified Health Care Professional |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90937. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90937 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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