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See a sample rate comparisonCPT 90947 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 Repeated Eval, Dialysis Procedure Other Than Hemodialysis Eg Peritoneal Dialysis Hemofiltration Or Other Continuous Renal Replacement Therapies Requiring Repeated Evaluations By A Physician Or Other Qualified Health Care Professional With Or Without Substantial Revision Of Dialysis Prescription
| 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 | G1 - URR reading <60 G5 - Most recent URR reading of 75 or greater |
| Complexity Level | Low |
| Medicare Fee Schedule | $106.22 national non-facility rate (2026) · View Medicare rates for 90947 |
| Medicaid Fee Schedule | $87.73 median of the 8 states in the free preview · View Medicaid rates for 90947 |
National average reimbursement for CPT 90947 by major payers:
$162.88
$157.90
$168.47
$194.69
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CPT 90947
5 of 25 sample ratesHigher to lower in this preview
Tanya Royster
Quincy Physicians & Surgeons Clinic S.C. D/B/A Quincy Medical Group
$347.00Published rateJocelyn Lorenzo
$241.52Published rateKaren Severson
Loyola University Medical Center
$201.69Published rateMichael Naylor
The Board Of Trustees Of The University Of Illinois
$161.58Published rateJulia Loza-Vega
Town Center Orthopaedic Associates, P.C.
$101.90Published rate
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See a sample payer proposalCPT 90947 vs. Other Dialysis Services and Procedures Codes
The CPT 90947 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 90947 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. |
| 90947-CPT | Low | Dialysis Repeated Eval, Dialysis Procedure Other Than Hemodialysis Eg Peritoneal Dialysis Hemofiltration Or Other Continuous Renal Replacement Therapies Requiring Repeated Evaluations By A Physician Or Other Qualified Health Care Professional With Or Without Substantial Revision Of Dialysis Prescription |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90947. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90947 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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