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CPT 90935: Hemodialysis Treatment
CPT code 90935 represents an in-person hemodialysis treatment that removes toxins and excess fluid from the blood via intra-arterial or intravenous access. The code includes the dialysis procedure and any related evaluation and management performed by the same provider on the same day. Hemodialysis is a critical national service for patients with end-stage renal disease and other serious kidney conditions; consistent coding for dialysis affects clinical workflow, facility billing, and payment policy across outpatient dialysis centers and hospital dialysis units. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. This publication explains the clinical context of 90935, typical sites of service, commonly associated diagnoses such as end-stage renal disease and chronic kidney disease, and how 90935 relates to adjacent codes like 90937 that address more complex or repeatedly evaluated dialysis sessions. Readers will find an overview of payer coverage considerations, commonly used modifiers (listed separately), and the provider specialties typically associated with billing this service, including nephrology and internal medicine. The content is intended to clarify coding scope and clinical context for administrators, billing staff, and clinicians involved in dialysis service delivery without offering clinical or billing advice.
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Billing Code Overview
CPT code 90935 describes a hemodialysis procedure in which blood is removed via an intra-arterial or intravenous access, filtered through a semipermeable membrane to remove impurities, and returned to the patient. The code encompasses performance of the dialysis treatment itself and includes any same-day related evaluation and management service by the same provider that is related to the dialysis.
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Service type: Hemodialysis treatment
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Typical site of service: Dialysis center or hospital-based dialysis unit
National Reimbursement Benchmarks
Medicare’s mean rate of $62.8 sits substantially below BUCA’s average commercial mean of $479, reflecting a large gulf between government and commercial reimbursements for CPT 90935. The difference of $416.2 highlights how much higher commercial payers can be relative to Medicare, with BUCA positioned well above the other national commercial means.
Dispersion measured as P75 minus P25 is widest for Blue Cross Blue Shield at $602.4 (P75 $1,015.7 minus P25 $413.0), indicating the greatest variability across its national rates. Aetna and UnitedHealth Group are among the tightest: Aetna’s interquartile spread is $35.6 (P75 $90.0 minus P25 $54.0) and UnitedHealth Group’s spread is $69.0 (P75 $146.9 minus P25 $74.9). Cigna’s spread is $70.9 and BUCA’s interquartile spread is $367.7, showing intermediate dispersion.