CPT 90937
Global 000 ActiveHemodialysis repeated eval
CPT 90937 Billing & Documentation Guide
CPT code 90937 (Hemodialysis repeated eval) is classified under Dialysis with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.06, a non-facility practice expense RVU of 0.46, and a malpractice RVU of 0.13, a total non-facility RVU of 2.65 and facility RVU of 2.65. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $89.96, though rates vary from $84.24 to $121.96 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 90937, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 90937 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 90937 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 90937
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.06 | 2.06 |
| Practice Expense RVU | 0.46 | 0.46 |
| Malpractice RVU | 0.13 | 0.13 |
| Total RVU | 2.65 | 2.65 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 90937
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $91.81 | $91.81 | $89.14 - $100.86 | 29 |
| Florida | $92.67 | $92.67 | $90.02 - $95.78 | 3 |
| Georgia | $88.77 | $88.77 | $87.69 - $89.84 | 2 |
| Illinois | $92.19 | $92.19 | $89.62 - $94.69 | 4 |
| Michigan | $89.35 | $89.35 | $87.74 - $90.95 | 2 |
| North Carolina | $85.92 | $85.92 | $85.92 - $85.92 | 1 |
| New York | $95.11 | $95.11 | $86.45 - $99.54 | 5 |
| Ohio | $87.21 | $87.21 | $87.21 - $87.21 | 1 |
| Pennsylvania | $89.12 | $89.12 | $87.01 - $91.22 | 2 |
| Texas | $88.35 | $88.35 | $86.82 - $90.59 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 90937
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 90937 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0692T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11000 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 11001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 90937
What does CPT code 90937 mean? +
CPT code 90937 represents: Hemodialysis repeated eval. It's in the Dialysis category with a global period of 000.
What is the Medicare reimbursement for CPT 90937? +
The 2026 Medicare national average non-facility payment for CPT 90937 is $89.96. Rates range from $84.24 to $121.96 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 90937? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 90937? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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