Cost analysis for CPT 90960 — Dialysis services (4 or more physician visits per month), patient 20 years of age and older
Average Medicare Payment
$275.42
2023 data
Total Payments (2023)
$333.2M
Services (2023)
1.2M
Price Change (2014–2023)
+24.6%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $220.99 | $490.9M | 2.2M | — |
| 2015 | $220.75 | $490.0M | 2.2M | -0.1% |
| 2016 | $220.65 | $494.6M | 2.2M | -0.0% |
| 2017 | $220.73 | $494.8M | 2.2M | +0.0% |
| 2018 | $221.30 | $493.7M | 2.2M | +0.3% |
| 2019 | $223.95 | $494.3M | 2.2M | +1.2% |
| 2020 | $228.69 | $495.1M | 2.2M | +2.1% |
| 2021 | $286.38 | $478.4M | 1.7M | +25.2% |
| 2022 | $282.47 | $390.1M | 1.4M | -1.4% |
| 2023 | $275.42 | $333.2M | 1.2M | -2.5% |
The most expensive state pays 1.5x more than the cheapest for this procedure. AK averages $348.04 vs MP at $233.79.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $348.04 | $910.1K | 2.6K | 5 |
| DC | $305.17 | $1.8M | 5.9K | 26 |
| NY | $302.93 | $25.6M | 84.7K | 437 |
| NJ | $296.25 | $12.4M | 42.0K | 238 |
| CA | $293.19 | $45.8M | 156.2K | 624 |
| MD | $292.08 | $11.8M | 40.3K | 157 |
| CT | $290.95 | $3.2M | 11.0K | 79 |
| MA | $286.14 | $5.7M | 19.8K | 115 |
| IL | $281.87 | $15.3M | 54.5K | 298 |
| MT | $281.60 | $708.0K | 2.5K | 16 |
| NH | $281.35 | $1.4M | 5.0K | 21 |
| CO | $281.02 | $2.7M | 9.5K | 80 |
| PA | $278.69 | $12.5M | 44.9K | 296 |
| FL | $278.29 | $21.2M | 76.1K | 462 |
| WA | $277.99 | $3.2M | 11.4K | 77 |
| DE | $276.66 | $1.9M | 7.0K | 38 |
| VA | $276.28 | $8.8M | 31.8K | 180 |
| RI | $276.28 | $1.1M | 3.9K | 25 |
| OR | $274.56 | $1.9M | 7.0K | 58 |
| NM | $274.36 | $2.3M | 8.3K | 37 |
| MI | $273.82 | $10.1M | 37.0K | 202 |
| NV | $272.53 | $3.5M | 13.0K | 90 |
| HI | $271.80 | $2.3M | 8.6K | 33 |
| TX | $271.27 | $32.0M | 118.0K | 617 |
| ND | $270.94 | $801.7K | 3.0K | 14 |
| PR | $270.86 | $282.0K | 1.0K | 11 |
| GA | $269.96 | $12.0M | 44.3K | 241 |
| LA | $268.38 | $5.5M | 20.3K | 110 |
| OH | $268.08 | $7.2M | 26.7K | 220 |
| MN | $267.76 | $1.7M | 6.4K | 60 |
| WV | $267.45 | $1.2M | 4.6K | 33 |
| NC | $267.01 | $12.2M | 45.9K | 261 |
| ME | $266.65 | $985.3K | 3.7K | 23 |
| MO | $266.33 | $5.0M | 18.9K | 122 |
| UT | $266.17 | $1.5M | 5.6K | 44 |
| SC | $266.09 | $6.9M | 26.0K | 129 |
| VT | $265.85 | $172.3K | 648 | 5 |
| AZ | $264.70 | $5.1M | 19.2K | 148 |
| WY | $264.26 | $118.4K | 448 | 5 |
| KY | $264.07 | $3.8M | 14.5K | 97 |
| ID | $263.74 | $986.7K | 3.7K | 17 |
| SD | $263.13 | $752.8K | 2.9K | 17 |
| IN | $262.62 | $5.9M | 22.6K | 157 |
| GU | $262.29 | $371.9K | 1.4K | 5 |
| KS | $261.85 | $2.1M | 7.9K | 40 |
| WI | $261.46 | $4.7M | 17.9K | 88 |
| IA | $260.82 | $1.8M | 6.8K | 38 |
| MS | $260.58 | $5.8M | 22.4K | 71 |
| OK | $260.00 | $2.6M | 10.0K | 62 |
| TN | $259.41 | $6.6M | 25.3K | 134 |
| NE | $259.02 | $932.0K | 3.6K | 25 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Sherleen Mohamdi-Osman | Internal Medicine | HI | $842.5K | 3.1K | $275.96 |
| Mark Bevan | Nephrology | NM | $576.8K | 2.1K | $272.74 |
| Aroti Hegde | Nephrology | VA | $316.1K | 1.0K | $313.56 |
| Brajesh Bhatla | Nephrology | TX | $302.9K | 1.1K | $270.65 |
| Ogbonnaya Aneziokoro | Nephrology | IL | $301.4K | 1.0K | $291.24 |
| Mandeep Sahani | Nephrology | AZ | $300.2K | 1.1K | $270.20 |
| Melody Dumlao | Nephrology | CA | $299.9K | 1.1K | $281.34 |
| Jim-Jer Hwu | Nephrology | CA | $289.3K | 973 | $297.30 |
| Hone Kaw | Nephrology | CA | $284.2K | 955 | $297.63 |
| Ajith Kuriakose | Nephrology | TX | $281.4K | 1.0K | $273.48 |
| Lakhi Sakhrani | Nephrology | CA | $280.1K | 941 | $297.66 |
| Kevin Pham | Nephrology | CA | $269.8K | 901 | $299.48 |
| Thong Do | Internal Medicine | CA | $269.2K | 1.1K | $238.04 |
| Padma Yarlagadda | Nephrology | CA | $267.2K | 809 | $330.32 |
| Yudh Gupta | Nephrology | DC | $253.6K | 817 | $310.36 |
| Parham Mokri | Nephrology | CA | $253.5K | 895 | $283.29 |
| Henry Lipner | Nephrology | NY | $252.7K | 804 | $314.33 |
| Sevag Balikian | Nephrology | CA | $252.6K | 850 | $297.18 |
| Cosmo Fraser | Nephrology | CA | $250.8K | 907 | $276.54 |
| Oday Saeed | Nephrology | CA | $243.7K | 866 | $281.43 |
Based on the data, CPT 90960 shows a 1.5x variation in pricing across states — moderate variation by Medicare standards.
Costs have increased 24.6% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.