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See a sample rate comparisonCPT 90945 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.
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
| 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 GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | $77.16 national non-facility rate (2026) · View Medicare rates for 90945 |
| Medicaid Fee Schedule | $62.705 median of the 8 states in the free preview · View Medicaid rates for 90945 |
National average reimbursement for CPT 90945 by major payers:
$112.69
$106.35
$119.25
$133.75
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CPT 90945
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$210.45Published rateLubov Romantseva
Rush University Medical Center
$160.17Published rateShalini Chawla
Shalini Chawla Md LLC
$145.03Published rateJohn Millichap
$119.76Published rateDavid Miller
Town Center Orthopaedic Associates, P.C.
$78.91Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 90945 vs. Other Dialysis Services and Procedures Codes
The CPT 90945 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 90945 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 90945. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90945 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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Frequently Asked Questions
The CPT 90945 fee schedule is influenced by several key factors. These include government-set reimbursement rates from programs like Medicare and Medicaid, which often serve as a benchmark. Private insurance companies also negotiate their own rates, which can vary significantly. Geographic location plays a role, as healthcare service costs, including administrative and operational expenses, can be higher in urban areas compared to rural ones. Finally, the type of provider delivering the service, such as a hospital versus a private practice, can impact the fee schedule. For a more precise understanding of fees based on your specific location and CPT code, it is recommended to use Payerprice's fee schedule lookup tool.