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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 90961
  4. Cost Analysis

How Much Does Dialysis services, 2-3 physician visits per month (20 years or older) Cost on Medicare?

Cost analysis for CPT 90961 — Dialysis services, 2-3 physician visits per month (20 years or older)

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Average Medicare Payment

$226.54

2023 data

Total Payments (2023)

$91.4M

Services (2023)

398.2K

Price Change (2014–2023)

+22.4%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2014$185.04$126.3M681.6K—
2015$184.49$127.7M690.2K-0.3%
2016$184.02$129.7M703.3K-0.3%
2017$184.26$131.4M710.8K+0.1%
2018$184.62$131.7M710.4K+0.2%
2019$186.51$133.5M710.7K+1.0%
2020$189.99$123.4M645.3K+1.9%
2021$234.14$125.9M533.0K+23.2%
2022$231.42$107.8M460.8K-1.2%
2023$226.54$91.4M398.2K-2.1%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.5x more than the cheapest for this procedure. AK averages $287.24 vs VI at $192.01.

StateAvg PaymentTotal PaymentsServicesProviders
AK$287.24$288.4K1.0K5
DC$253.66$957.3K3.8K27
NY$251.11$4.9M19.6K335
NJ$244.86$2.6M10.8K198
CA$243.75$15.0M61.6K620
CT$243.33$623.9K2.6K57
MD$242.22$2.2M9.1K150
MA$241.70$2.2M9.0K109
IL$235.29$3.5M15.0K254
NH$232.71$252.0K1.1K23
WA$232.44$2.8M12.2K106
CO$230.22$996.9K4.3K83
FL$230.15$5.5M23.9K399
OR$229.40$1.2M5.2K74
RI$227.70$92.4K40615
MI$227.30$2.6M11.2K200
PA$227.20$2.5M11.1K229
VA$226.23$1.7M7.6K155
MT$226.00$265.6K1.2K19
TX$225.38$7.9M35.2K551
ND$224.82$344.6K1.5K16
NM$224.53$952.7K4.2K46
ME$222.78$257.8K1.2K19
MN$222.11$2.3M10.2K104
WV$221.71$466.0K2.1K31
GA$221.69$2.9M13.3K235
WY$221.26$123.2K5577
SD$220.12$568.6K2.6K17
DE$219.93$335.0K1.5K41
OH$219.71$2.1M9.4K206
VT$219.61$90.9K4145
LA$218.79$1.7M7.6K113
ID$218.69$450.9K2.1K26
HI$218.62$610.8K2.8K36
SC$218.45$1.4M6.2K131
MO$218.41$2.4M10.8K135
KY$218.02$836.8K3.8K79
IN$217.15$1.8M8.2K139
NC$217.03$2.0M9.2K239
KS$216.69$505.5K2.3K25
IA$215.63$524.2K2.4K34
AZ$215.32$1.6M7.2K129
WI$214.99$1.0M4.8K74
UT$214.59$379.6K1.8K35
PR$214.52$165.6K7729
OK$214.48$1.4M6.7K74
NV$213.99$594.5K2.8K65
MS$213.44$1.2M5.4K80
TN$213.35$1.5M7.1K130
NE$213.25$585.6K2.7K33
GU$212.11$25.0K1183

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
George HonNephrologyCA$246.1K1.0K$244.83
Rodolfo BatarseNephrologyCA$192.3K809$237.72
Mark BevanNephrologyNM$170.8K758$225.39
Subil GoNephrologyCA$164.2K697$235.62
Raghavender BoothpurNephrologyCA$158.6K677$234.29
Sheldon LeongNephrologyCA$155.8K648$240.43
Mallareddy MaddulaNephrologyCA$152.4K634$240.45
David LeflerNephrologyAK$148.3K517$286.90
Elwin BustosNephrologyDC$140.0K533$262.69
Ronak ShahNephrologyCA$135.4K563$240.42
Balbir SinghNephrologyCA$133.2K567$234.92
Haresh KhilnaniNephrologyCA$132.4K534$247.94
David PaiNephrologyCA$129.3K536$241.27
Ileana HelmsNephrologyCA$125.8K470$267.73
Amandeep GillNephrologyWA$123.8K529$234.07
Fred LuiNephrologyCA$123.8K462$267.87
Essam MaasaraniNephrologyCA$121.9K502$242.74
Dorsa MaryskaNephrologyCA$121.8K529$230.21
Johan WinotoNephrologyCA$120.9K514$235.18
Bryan StoneNephrologyCA$115.6K500$231.19

🤔 Is Dialysis services, 2-3 physician visits per month (20 years or older) Overpriced?

Based on the data, CPT 90961 shows a 1.5x variation in pricing across states — moderate variation by Medicare standards.

Costs have increased 22.4% 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.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.