NAICS 621492 Quarterly Industry Report
Kidney Dialysis Centers
Comprehensive industry research for valuation professionals, business owners, buyers, and lenders
NAICS Code: 621492Sector: Health Care and Social Assistance (62)Updated: Q1 2026
About This Report
This industry profile for Kidney Dialysis Centers (NAICS 621492) draws on data from the U.S. Census Bureau[9], Centers for Medicare and Medicaid Services[8], CDC[6], and SBA size standards database[7]. Published by Fair Market Value and updated quarterly, it provides valuation professionals, healthcare investors, and nephrology industry analysts with current market data. Additional data is drawn from Bureau of Labor Statistics[10].. All quantitative claims are sourced to publicly verifiable databases.
Industry Snapshot
Key metrics for the kidney dialysis centers industry.
NAICS Sector
62
Health Care and Social Assistance
Industry Definition & Overview
Kidney Dialysis Centers (NAICS 621492) encompasses freestanding outpatient establishments known as kidney or renal dialysis centers primarily engaged in providing dialysis treatment services to patients suffering from renal failure per the U.S. Census Bureau[5]. These centers administer hemodialysis and peritoneal dialysis under the supervision of nephrologists and trained clinical staff.
Roughly 7,556 centers employ 129,338 workers per Census data. Market size reached $27 billion in 2024 and is projected to grow to $43 billion by 2032 at a 6 percent compound annual rate. Chronic kidney disease affects 35.5 million Americans - nearly 1 in 7 adults - per the CDC[6]. DaVita Inc. operates roughly 37 percent of U.S. dialysis centers, while Fresenius Medical Care holds approximately 38 percent, together controlling about 75 percent of the market. Independent providers and hospital-based programs serve the remaining patient population.
Per the SBA Table of Size Standards[7], the size standard is $41.5 million in average annual receipts. Medicare covers dialysis through the End-Stage Renal Disease (ESRD) program, with CMS[8] setting the CY 2024 base payment rate at $271.02 per treatment under the ESRD Prospective Payment System. Facilities must meet Medicare Conditions for Coverage including patient care standards, water treatment requirements, infection control protocols, and staff qualifications. Home dialysis adoption is accelerating, supported by the CMS ESRD Treatment Choices model and new portable dialysis technologies. Kidney Care Choices payment models reward providers for slowing disease progression and increasing home dialysis and transplant referrals.
What's Included in This Industry
- In-center hemodialysis treatment sessions and monitoring
- Peritoneal dialysis training and home program support
- Home hemodialysis setup, training, and remote monitoring
- Nephrologist oversight and vascular access management
- Anemia management and erythropoietin therapy administration
- Dialysis water treatment system operation and compliance
- Patient nutrition counseling and renal dietitian services
- Social work services and transplant referral coordination
- Infection control and bloodborne pathogen prevention programs
- Medicare ESRD billing and quality reporting compliance
NAICS Classification Hierarchy
| Level | Description | Code |
|---|---|---|
| Sector | Health Care and Social Assistance | 62 |
| Subsector | Ambulatory Health Care Services | 621 |
| Industry Group | Outpatient Care Centers | 6214 |
| NAICS Industry | Other Outpatient Care Centers | 62149 |
| National Industry | Kidney Dialysis Centers | 621492 |
Related NAICS Codes
| Code | Description | Relationship |
|---|---|---|
| 622110 | General Medical and Surgical Hospitals | General Medical and Surgical Hospitals operate inpatient dialysis departments and serve as referral destinations for dialysis patients requiring hospitalization for complications including vascular access failure, fluid overload, and electrolyte emergencies |
| 621111 | Offices of Physicians (except Mental Health Specialists) | Offices of Physicians (General) include nephrologist practices that prescribe and oversee dialysis treatment, with physician offices serving as the referral source for new dialysis patients and managing comorbid conditions alongside renal care |
| 621610 | Home Health Care Services | Home Health Care Services support home dialysis patients with nursing visits, equipment monitoring, and care coordination that enables patients to receive peritoneal or home hemodialysis outside freestanding center settings |
| 621498 | All Other Outpatient Care Centers | All Other Outpatient Care Centers provide ancillary outpatient services that dialysis patients may require, including laboratory testing, imaging, and specialty consultations for the multiple comorbidities common in the renal failure population |
| 339113 | Surgical Appliance and Supplies Manufacturing | Surgical and Medical Instrument Manufacturing produces dialysis machines, water treatment systems, and vascular access devices that represent primary capital and operating expenditures for dialysis center buildout and ongoing treatment delivery |
| 524114 | Direct Health and Medical Insurance Carriers | Direct Health and Medical Insurance Carriers administer commercial coverage and Medicare Advantage plans for dialysis patients, with insurance coordination essential given the ESRD program's transition from Medicare to commercial payer obligations |
Geographic Concentration
Top states by share of national establishments.
| # | State | % Est. | Total Est. |
|---|---|---|---|
| 1 | Texas | 10.0% | 843 |
| 2 | California | 9.9% | 838 |
| 3 | Florida | 7.4% | 627 |
| 4 | Georgia | 5.0% | 423 |
| 5 | Pennsylvania | 4.5% | 383 |
| 6 | Ohio | 4.5% | 378 |
| 7 | Illinois | 4.2% | 351 |
| 8 | New York | 3.9% | 332 |
| 9 | North Carolina | 3.1% | 264 |
| 10 | Tennessee | 3.1% | 263 |
% Of Establishments
0%
10%
Source: County Business Patterns, U.S. Census Bureau[3]
SBA Lending Summary
24
Total SBA Loans
$43.5M
Total Loan Volume
$1.8M
Average Loan Size
11 yrs
Average Loan Term
10.33%
Average Interest Rate
376
Jobs Supported
Source: SBA 7(a) Program Data, U.S. Small Business Administration — FY 2025[4]
Key Insight: Per the SBA Table of Size Standards[7], Kidney Dialysis Centers (NAICS 621492) has a size standard of $41.5 million in average annual receipts for federal contracting purposes. SBA lending programs[11] support facility acquisition, dialysis equipment investment, and center expansion for qualifying dialysis center operators. Eligible businesses can access SBA 7(a) loans[12] for working capital, equipment, and acquisition financing, while 504 loans[13] support major fixed-asset purchases including real estate and heavy machinery.
Top SBA Lenders
| # | Lender | Loans | Volume | Avg Loan |
|---|---|---|---|---|
| 1 | Live Oak Banking Company | 8 | $40.0M | $5.0M |
| 2 | Zions Bank, A Division of | 8 | $3.0M | $375K |
| 3 | JPMorgan Chase Bank, National Association | 8 | $480K | $60K |
Frequently Asked Questions
Common questions about this industry.
What is the NAICS code for dialysis centers?
NAICS 621492 covers freestanding kidney or renal dialysis centers providing hemodialysis and peritoneal dialysis treatment to patients with renal failure per the U.S. Census Bureau[5].
How large is the dialysis center market?
Roughly 7,556 centers employ 129,338 workers with market size reaching $27 billion in 2024 per Census Bureau[9] data, projected to grow to $43 billion by 2032 at a 6 percent compound annual rate.
What is the SBA size standard for dialysis centers?
The SBA size standard[7] is $41.5 million in average annual receipts, determining eligibility for federal small business contracting programs and SBA lending products.
How prevalent is chronic kidney disease?
Chronic kidney disease affects 35.5 million Americans - nearly 1 in 7 adults - per the CDC[6], creating sustained demand for dialysis services among patients who progress to end-stage renal disease.
Who controls the U.S. dialysis market?
DaVita Inc. and Fresenius Medical Care together control about 75 percent of the market, with DaVita operating roughly 37 percent and Fresenius holding about 38 percent of U.S. dialysis centers per industry tracking data.
What is the Medicare dialysis payment rate?
CMS[8] set the CY 2024 base payment rate at $271.02 per treatment under the ESRD Prospective Payment System, with adjustments for patient case mix, geographic wage index, and facility characteristics.
Is home dialysis growing?
Home dialysis adoption is accelerating, supported by the CMS ESRD Treatment Choices model and new portable technologies per CMS[8] innovation center data, with payment models rewarding providers for increasing home dialysis rates and transplant referrals.
What regulations govern dialysis centers?
Facilities must meet Medicare Conditions for Coverage including patient care standards, water treatment requirements, infection control protocols, and staff qualifications per CMS[8] regulatory guidance, with state licensing adding additional facility and operational requirements.
Sources & References
Government datasets and editorial sources used in this report.
- [1]U.S. Bureau of Labor Statistics, Quarterly Census of Employment and Wages bls.gov
- [2]U.S. Census Bureau, Economic Census census.gov
- [3]U.S. Census Bureau, County Business Patterns census.gov
- [4]U.S. Small Business Administration, SBA 7(a) Loan Program Data data.sba.gov
- [5]U.S. Census Bureau census.gov
- [6]CDC cdc.gov
- [7]SBA Table of Size Standards sba.gov
- [8]CMS cms.gov
- [9]U.S. Census Bureau data.census.gov
- [10]Bureau of Labor Statistics bls.gov
- [11]SBA lending programs sba.gov
- [12]SBA 7(a) loans sba.gov
- [13]504 loans sba.gov
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