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CPT code 36860: Cannula declotting, external cannula, no revision2026 Medicare rate & RVUs in Washington, DC area

Reports clearing clot from an external cannula associated with an arteriovenous shunt or fistula when the access itself is not revised.

CMS RVU26DEffective Oct 1, 2026One payment locality

In Washington, DC area, Medicare pays $294.92 for 36860 in the office and $106.45 when it’s performed in a hospital or facility.

$294.92Office (non-facility)
$106.45Hospital or facility
+14.2%vs the national office rate ($258.19)

Check a contract rate as a % of Medicare · 36860 nationwide

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

We’ll open 36860 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 36860 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 36860 covers

This service clears thrombus from an external cannula used with an arteriovenous shunt or fistula for hemodialysis. It is distinct from removing clot from the access circuit itself or surgically revising the access. A physician who manages dialysis access, commonly a vascular surgeon or access surgeon, may perform it when cannula obstruction interferes with use of the access.

Report the code when documentation identifies the external cannula as the site of clot and shows that declotting was performed without access revision. Record the access involved, the obstructing clot, the work performed, and the result. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery is not paid; co-surgeon and team-surgery billing 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 Washington, DC area compares for 36860

Across 109 of 109 payment localities, the office rate for 36860 runs from $225.16 in Arkansas to $335.14 in San Benito County, CA. Washington, DC area pays $294.92. The RVUs are the same everywhere; the geographic indexes change the dollars.

36860 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$294.92
  2. Los Angeles, CA · California$287.30−$7.62
  3. Miami, FL · Florida$291.44−$3.48
  4. Chicago, IL · Illinois$281.59−$13.33
  5. Manhattan, NY · New York$300.82+$5.90
  6. Alaska · Alaska$294.69−$0.23
  7. Alabama · Alabama$228.83−$66.09

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

36860 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$225.16$87.72
ArizonaArizona$250.29$95.26
Bakersfield, CACalifornia$269.64$94.29
Chico, CACalifornia$268.26$92.91
El Centro, CACalifornia$268.35$93.00
Fresno, CACalifornia$268.26$92.91
Hanford, CACalifornia$268.26$92.91
Madera, CACalifornia$268.26$92.91

36860 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

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

$225.16

$301.70

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
36860 office rate range by state
State / territoryOffice rate rangeLocalities
AK$294.691
AL$228.831
AR$225.161
AZ$250.291
CA$268.26–$335.1429
CO$266.491
CT$276.601
DC$294.921
DE$254.691
FL$259.03–$291.443
GA$242.49–$264.622
GU$275.091
HI$275.091
IA$232.981
ID$235.161
IL$252.49–$281.594
IN$236.611
KS$232.871
KY$237.241
LA$237.27–$250.142
MA$265.09–$293.082
MD$259.56–$294.923
ME$237.69–$250.322
MI$245.10–$263.732
MN$251.291
MO$233.50–$249.793
MS$229.321
MT$258.151
NC$240.271
ND$248.071
NE$234.071
NH$263.261
NJ$278.62–$291.582
NM$247.031
NV$255.521
NY$244.35–$310.185
OH$243.041
OK$235.591
OR$252.43–$274.382
PA$242.85–$269.862
PR$259.871
RI$263.391
SC$242.281
SD$246.881
TN$234.311
TX$241.17–$266.578
UT$245.911
VA$250.19–$294.922
VI$259.871
VT$248.021
WA$264.28–$298.232
WI$239.021
WV$242.521
WY$253.761

See 36860 in every payment locality

How the 36860 rate is calculated

Each of 36860’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 · 36860

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.96

1.96 RVUs× 1.000 GPCI

Practice expense5.26

5.26 RVUs× 1.000 GPCI

Malpractice0.51

0.51 RVUs× 1.000 GPCI

Adjusted RVUs

7.7300

Conversion factor

$33.4009

Medicare rate

$258.19

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

4,560

Code
36860
Physician work
1.96
Practice expense
5.26
Malpractice
0.51

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 36860 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.96× 1.0542.0658
Practice expense5.26× 1.1786.1963
Malpractice0.51× 1.1130.5676
Total RVUs8.8297
Conversion factor× 33.4009

Office rate, Washington, DC area$294.92

Office: (1.96 × 1.054 + 5.26 × 1.178 + 0.51 × 1.113) × $33.4009 = $294.92

Facility: (1.96 × 1.054 + 0.47 × 1.178 + 0.51 × 1.113) × $33.4009 = $106.45

Open 36860 in the RVU calculator

Payment rules and modifiers for 36860

The CMS indicators that decide how 36860 is paid alongside other services.

CMS payment indicators · 36860

Cannula declotting, external cannula, no revision

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

36860 without 51 · national office

$258.19

Cannula declotting, external cannula, no revision

36860-51 · Second procedure: 50%

$129.10

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

Codes related to 36860

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

Codes related to 36860
CodeHow it relatesOffice range, Washington, DC area
Same family
36861Cannula declotting, internal cannulaRelated cannula declotting code associated with revision of the access.No office rate
Used instead
36831Fistula thrombectomy, open, without revisionUsed for open thrombectomy of the fistula rather than clot limited to the external cannula.No office rate
36832Fistula revision, open, without thrombectomyDescribes open revision of an arteriovenous fistula, not isolated external-cannula declotting.No office rate
36833Fistula revision, open, with thrombectomyFor fistula revision with thrombectomy when the access itself requires operative treatment.No office rate

How 36860 has changed in Washington, DC area

36860 · Office / nonfacility

$294.92

Effective 2026-10-01

The base rate is $36.12 higher than on 2025-10-01, moving from $258.80 to $294.92 (14.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $258.80changed to$294.92

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.01 changed to 1.96
    • Practice expense RVU 4.43 changed to 5.26
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $267.12changed to$258.80

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.45 changed to 4.43

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $262.76changed to$267.12

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $276.68changed to$262.76

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.46 changed to 4.45
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $288.63changed to$276.68

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.50 changed to 4.46
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $298.73changed to$288.63

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.71 changed to 4.50
    • Malpractice RVU 0.48 changed to 0.51

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $299.17changed to$298.73

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.55 changed to 4.71
    • Malpractice RVU 0.49 changed to 0.48
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $300.75changed to$299.17

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.68 changed to 4.55
    • Malpractice RVU 0.48 changed to 0.49
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $262.70changed to$300.75

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.80 changed to 4.68
    • Malpractice RVU 0.49 changed to 0.48

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $246.41changed to$262.70

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.76 changed to 3.80
    • Malpractice RVU 0.18 changed to 0.49
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $245.65changed to$246.41

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice RVU 0.17 changed to 0.18
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $245.64changed to$245.65

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.75 changed to 3.76
    • Malpractice RVU 0.16 changed to 0.17

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $244.42changed to$245.64

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $247.87changed to$244.42

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.25 changed to 0.16
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $245.59changed to$247.87

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 4.02 changed to 3.75
    • Malpractice RVU 0.26 changed to 0.25
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $245.59

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$294.92$106.45RVU26D
2026-07-01$294.92$106.45RVU26C
2026-04-01$294.92$106.45RVU26B
2026-01-01$294.92$106.45RVU26A
2025-10-01$258.80$117.29RVU25D
2025-07-01$258.80$117.29RVU25C
2025-04-01$258.80$117.29RVU25B
2025-01-01$258.80$117.29RVU25A
2024-10-01$267.12$119.91RVU24D
2024-07-01$267.12$119.91RVU24C
2024-04-01$267.12$119.91RVU24B
2024-03-09$267.12$119.91RVU24AR
2024-01-01$262.76$117.96RVU24A
2023-10-01$276.68$124.06RVU23D
2023-07-01$276.68$124.06RVU23C
2023-04-01$276.68$124.06RVU23B
2023-01-01$276.68$124.06RVU23A
2022-10-01$288.63$128.23RVU22D
2022-07-01$288.63$128.23RVU22C
2022-04-01$288.63$128.23RVU22B
2022-01-01$288.63$128.23RVU22A
2021-10-01$298.73$127.94RVU21D
2021-07-01$298.73$127.94RVU21C
2021-04-01$298.73$127.94RVU21B
2021-01-01$298.73$127.94RVU21A
2020-10-01$299.17$130.84RVU20D
2020-07-01$299.17$130.84RVU20C
2020-04-01$299.17$130.84RVU20B
2020-01-01$299.17$130.84RVU20A
2019-10-01$300.75$128.35RVU19D
2019-07-01$300.75$128.35RVU19C
2019-04-01$300.75$128.35RVU19B
2019-01-01$300.75$128.35RVU19A
2018-10-01$262.70$139.50RVU18D
2018-07-01$262.70$139.50RVU18C
2018-04-01$262.70$139.50RVU18B
2018-01-01$262.70$139.50RVU18AR1
2017-10-01$246.41$127.49RVU17D
2017-07-01$246.41$127.49RVU17C
2017-04-01$246.41$127.49RVU17B
2017-01-01$246.41$127.49RVU17A
2016-10-01$245.65$127.00RVU16D
2016-07-01$245.65$127.00RVU16C
2016-04-01$245.65$127.00RVU16B
2016-01-01$245.65$127.00RVU16A
2015-10-01$245.64$127.43RVU15D
2015-07-01$245.64$127.43RVU15C
2015-04-01$244.42$126.80RVU15B
2015-01-01$244.42$126.80RVU15A
2014-10-01$247.87$130.75RVU14D
2014-07-01$247.87$130.75RVU14C
2014-04-01$247.87$130.75RVU14B
2014-01-01$247.87$130.75RVU14A
2013-10-01$245.59$123.72RVU13D
2013-07-01$245.59$123.72RVU13C
2013-04-01$245.59$123.72RVU13B
2013-01-01$245.59$123.72RVU13AR

Price 36860 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

36860 billing questions

How is this different from 36831?

Use 36860 for clot cleared from the external cannula without revising the access. Code 36831 describes open thrombectomy of the arteriovenous fistula itself.

When would 36861 be considered instead?

36861 is the related cannula-declotting code associated with revision. This code is for declotting the external cannula without access revision.

What documentation supports reporting 36860?

Document that the clot was in the external cannula, the declotting work performed, and whether the access was revised. The record should distinguish cannula clearing from thrombectomy of the access.

Is same-day care included in the payment?

Yes. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

Can modifier 50 or an assistant-at-surgery claim be reported?

Modifier 50 is inappropriate for this code. CMS does not pay an assistant at surgery for it.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full; other procedures are subject to the standard multiple procedure reduction. Co-surgeon and team-surgery billing are not permitted.

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 36860PPRRVU2026_Oct_nonQPP.csv, line 4,560 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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