CPT code 36835: Dialysis access, thomas external shunt2026 Medicare rate & RVUs in Virginia

In Virginia, Medicare pays $455.66 for 36835 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 36835 nationwide

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

What 36835 covers

Code 36835 describes operative placement of a Thomas shunt, an external arteriovenous access for hemodialysis. The surgeon places arterial and venous cannulae and connects them through external tubing, creating a route for dialysis blood flow that remains outside the body. Vascular surgeons generally perform the operation in an operating room for a patient requiring hemodialysis access when an external shunt is selected rather than an internal fistula or graft.

Report 36835 when the operative documentation supports insertion of a Thomas-type external shunt; do not substitute it for creation of an internal AV fistula or graft. The operative report should identify the external shunt and document its placement, rather than only cannulation or revision of an existing access. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure setting, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate; assistant-at-surgery services are restricted from payment, and co-surgery and team surgery are 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.

How Virginia compares for 36835

Across 109 of 109 payment localities, the facility rate for 36835 runs from $422.76 in Arkansas to $582.38 in Alaska. Virginia pays $455.66. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

36835 rates by state

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

See 36835 in every payment locality

How the 36835 rate is calculated

Each of 36835’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.

Payment rules and modifiers for 36835

36835 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 36835

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

How 36835 has changed in Virginia

Price 36835 for an earlier date of service

Where the Virginia rate applies

Virginia is a Medicare payment area, not a city. Our Census mapping connects it to 628 cities and communities in Virginia. Some span more than one payment area; confirm with the service ZIP.

• Abbs Valley
• Abingdon
• Accomac
• Adwolf
• Afton
• Alberta
• Aldie
• Allison Gap

Browse all communities in Virginia

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

Open CMS sourceHow we calculate rates