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CPT code 36832: Fistula revision, open, without thrombectomy2026 Medicare rate & RVUs

Reports open surgical revision of a hemodialysis arteriovenous fistula when the access needs repair or reconstruction and thrombectomy is not performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities14.5K Medicare services in 2024

Medicare pays $688.39 for 36832 nationally in a facility.

Medicare rate · 36832

Fistula revision, open, without thrombectomy

Office or facility?

Work RVUs
13.16
Total RVUs
20.61
Global days
090

National rate · 2026

$688.39

Facility setting, before claim adjustments.

See every locality for 36832 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 36832 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 36832 covers

This service covers open repair or reconfiguration of an existing arteriovenous fistula used for hemodialysis. A vascular surgeon or another surgeon experienced in dialysis access may revise a fistula to address a structural or functional problem, such as a narrowed segment or an aneurysmal area. The operation is performed in a surgical setting and is distinct from creating a new access or removing clot from the fistula as part of the revision.

Report 36832 when the operative work revises the existing fistula without thrombectomy; when revision includes thrombectomy, the related code is 36833. The operative report should identify the access, the problem treated, the open revision performed, and whether clot removal was part of the operation. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 36832 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

36832 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$623.02
AlaskaUnavailable$867.35
ArizonaUnavailable$668.15
ArkansasUnavailable$615.16
Atlanta, GAUnavailable$714.21
Austin, TXUnavailable$684.63
Bakersfield, CAUnavailable$666.63
Baltimore area, MDUnavailable$731.78
Beaumont, TXUnavailable$668.10
Brazoria, TXUnavailable$666.27

36832 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
36832 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 36832 rate is calculated

Each of 36832’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 36832

RVUs × geographic indexes × conversion factor

Office or facility?

Work13.16

13.16 RVUs× 1.000 GPCI

Practice expense4.13

4.13 RVUs× 1.000 GPCI

Malpractice3.32

3.32 RVUs× 1.000 GPCI

Adjusted RVUs

20.6100

Conversion factor

$33.4009

Medicare rate

$688.39

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 36832

36832 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 36832

Fistula revision, open, without thrombectomy

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 36832

Fistula revision, open, without thrombectomy

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

36832 without 51 · national facility

$688.39

Fistula revision, open, without thrombectomy

36832-51 · Second procedure: 50%

$344.20

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

36832 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 36832

    Fistula revision, open, without thrombectomy13.16 wRVU

    Not priced

  • 36833

    Fistula revision, open, with thrombectomy14.14 wRVU

    Not priced

  • 36831

    Fistula thrombectomy, open, without revision10.73 wRVU

    Not priced

  • 36821

    Dialysis access, direct artery-to-vein connection11.6 wRVU

    Not priced

  • 36830

    AV graft creation, nonautologous graft11.73 wRVU

    Not priced

How to choose

36833Fistula revisionOpen, with thrombectomy
Choose 36833 when open fistula revision includes thrombectomy. Code 36832 is for revision without thrombectomy.
36831Fistula thrombectomyOpen, without revision
36831 is open clot removal without revision. If the surgeon revises the fistula without thrombectomy, use 36832.
36821Dialysis accessDirect artery-to-vein connection
36821 describes creation of a new direct arteriovenous connection. Code 36832 revises an existing fistula.
36830AV graft creationNonautologous graft
36830 describes creation of an arteriovenous access using a nonautologous graft; it is not revision of an existing fistula.

Codes related to 36832

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 36832
CodeHow it relatesNational office range
Same family
36833Fistula revision, open, with thrombectomyOpen revision of an arteriovenous fistula when thrombectomy is also performed.No office rate
Used instead
36831Fistula thrombectomy, open, without revisionOpen thrombectomy of an arteriovenous fistula without revision.No office rate
36821Dialysis access, direct artery-to-vein connectionOpen creation of a direct arteriovenous connection rather than revision of an existing fistula.No office rate
36830AV graft creation, nonautologous graftCreation of an arteriovenous access using a nonautologous graft, rather than revising an existing fistula.No office rate

36832 billing questions

How is 36832 different from 36833?

Use 36832 for open fistula revision without thrombectomy. When thrombectomy is performed as part of the revision, use 36833.

Can 36831 be reported with 36832 for clot removal?

36831 describes open thrombectomy without revision. When thrombectomy accompanies the open revision, 36833 is the corresponding code rather than separately reporting 36831 for that work.

What should the operative note document?

Document the existing dialysis fistula, the structural or functional problem, the open revision performed, and whether thrombectomy was included.

Can modifier 50 be used for a bilateral fistula revision?

CMS identifies bilateral adjustment as inappropriate for this code. The descriptor or anatomy makes modifier 50 unsuitable.

How are assistant and co-surgeon services handled?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 36832PPRRVU2026_Oct_nonQPP.csv, line 4,554 (RVU26D)

Open CMS sourceHow we calculate rates

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