Cost analysis for CPT 90961 — Dialysis services, 2-3 physician visits per month (20 years or older)
Average Medicare Payment
$226.54
2023 data
Total Payments (2023)
$91.4M
Services (2023)
398.2K
Price Change (2014–2023)
+22.4%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $185.04 | $126.3M | 681.6K | — |
| 2015 | $184.49 | $127.7M | 690.2K | -0.3% |
| 2016 | $184.02 | $129.7M | 703.3K | -0.3% |
| 2017 | $184.26 | $131.4M | 710.8K | +0.1% |
| 2018 | $184.62 | $131.7M | 710.4K | +0.2% |
| 2019 | $186.51 | $133.5M | 710.7K | +1.0% |
| 2020 | $189.99 | $123.4M | 645.3K | +1.9% |
| 2021 | $234.14 | $125.9M | 533.0K | +23.2% |
| 2022 | $231.42 | $107.8M | 460.8K | -1.2% |
| 2023 | $226.54 | $91.4M | 398.2K | -2.1% |
The most expensive state pays 1.5x more than the cheapest for this procedure. AK averages $287.24 vs VI at $192.01.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $287.24 | $288.4K | 1.0K | 5 |
| DC | $253.66 | $957.3K | 3.8K | 27 |
| NY | $251.11 | $4.9M | 19.6K | 335 |
| NJ | $244.86 | $2.6M | 10.8K | 198 |
| CA | $243.75 | $15.0M | 61.6K | 620 |
| CT | $243.33 | $623.9K | 2.6K | 57 |
| MD | $242.22 | $2.2M | 9.1K | 150 |
| MA | $241.70 | $2.2M | 9.0K | 109 |
| IL | $235.29 | $3.5M | 15.0K | 254 |
| NH | $232.71 | $252.0K | 1.1K | 23 |
| WA | $232.44 | $2.8M | 12.2K | 106 |
| CO | $230.22 | $996.9K | 4.3K | 83 |
| FL | $230.15 | $5.5M | 23.9K | 399 |
| OR | $229.40 | $1.2M | 5.2K | 74 |
| RI | $227.70 | $92.4K | 406 | 15 |
| MI | $227.30 | $2.6M | 11.2K | 200 |
| PA | $227.20 | $2.5M | 11.1K | 229 |
| VA | $226.23 | $1.7M | 7.6K | 155 |
| MT | $226.00 | $265.6K | 1.2K | 19 |
| TX | $225.38 | $7.9M | 35.2K | 551 |
| ND | $224.82 | $344.6K | 1.5K | 16 |
| NM | $224.53 | $952.7K | 4.2K | 46 |
| ME | $222.78 | $257.8K | 1.2K | 19 |
| MN | $222.11 | $2.3M | 10.2K | 104 |
| WV | $221.71 | $466.0K | 2.1K | 31 |
| GA | $221.69 | $2.9M | 13.3K | 235 |
| WY | $221.26 | $123.2K | 557 | 7 |
| SD | $220.12 | $568.6K | 2.6K | 17 |
| DE | $219.93 | $335.0K | 1.5K | 41 |
| OH | $219.71 | $2.1M | 9.4K | 206 |
| VT | $219.61 | $90.9K | 414 | 5 |
| LA | $218.79 | $1.7M | 7.6K | 113 |
| ID | $218.69 | $450.9K | 2.1K | 26 |
| HI | $218.62 | $610.8K | 2.8K | 36 |
| SC | $218.45 | $1.4M | 6.2K | 131 |
| MO | $218.41 | $2.4M | 10.8K | 135 |
| KY | $218.02 | $836.8K | 3.8K | 79 |
| IN | $217.15 | $1.8M | 8.2K | 139 |
| NC | $217.03 | $2.0M | 9.2K | 239 |
| KS | $216.69 | $505.5K | 2.3K | 25 |
| IA | $215.63 | $524.2K | 2.4K | 34 |
| AZ | $215.32 | $1.6M | 7.2K | 129 |
| WI | $214.99 | $1.0M | 4.8K | 74 |
| UT | $214.59 | $379.6K | 1.8K | 35 |
| PR | $214.52 | $165.6K | 772 | 9 |
| OK | $214.48 | $1.4M | 6.7K | 74 |
| NV | $213.99 | $594.5K | 2.8K | 65 |
| MS | $213.44 | $1.2M | 5.4K | 80 |
| TN | $213.35 | $1.5M | 7.1K | 130 |
| NE | $213.25 | $585.6K | 2.7K | 33 |
| GU | $212.11 | $25.0K | 118 | 3 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| George Hon | Nephrology | CA | $246.1K | 1.0K | $244.83 |
| Rodolfo Batarse | Nephrology | CA | $192.3K | 809 | $237.72 |
| Mark Bevan | Nephrology | NM | $170.8K | 758 | $225.39 |
| Subil Go | Nephrology | CA | $164.2K | 697 | $235.62 |
| Raghavender Boothpur | Nephrology | CA | $158.6K | 677 | $234.29 |
| Sheldon Leong | Nephrology | CA | $155.8K | 648 | $240.43 |
| Mallareddy Maddula | Nephrology | CA | $152.4K | 634 | $240.45 |
| David Lefler | Nephrology | AK | $148.3K | 517 | $286.90 |
| Elwin Bustos | Nephrology | DC | $140.0K | 533 | $262.69 |
| Ronak Shah | Nephrology | CA | $135.4K | 563 | $240.42 |
| Balbir Singh | Nephrology | CA | $133.2K | 567 | $234.92 |
| Haresh Khilnani | Nephrology | CA | $132.4K | 534 | $247.94 |
| David Pai | Nephrology | CA | $129.3K | 536 | $241.27 |
| Ileana Helms | Nephrology | CA | $125.8K | 470 | $267.73 |
| Amandeep Gill | Nephrology | WA | $123.8K | 529 | $234.07 |
| Fred Lui | Nephrology | CA | $123.8K | 462 | $267.87 |
| Essam Maasarani | Nephrology | CA | $121.9K | 502 | $242.74 |
| Dorsa Maryska | Nephrology | CA | $121.8K | 529 | $230.21 |
| Johan Winoto | Nephrology | CA | $120.9K | 514 | $235.18 |
| Bryan Stone | Nephrology | CA | $115.6K | 500 | $231.19 |
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.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.