CPT code 36905: Dialysis thrombectomy, peripheral balloon angioplasty2026 Medicare rate & RVUs in Illinois
Reports percutaneous removal or dissolution of thrombus in a dialysis access circuit together with balloon angioplasty of a stenosis in its peripheral segment.
Medicare pays $2,066.80–$2,290.90 for 36905 in the office in Illinois, from Rest of Illinois to Suburban Chicago, IL. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 36905 covers
This service treats a thrombosed or occluded hemodialysis access, such as an arteriovenous fistula or graft. A vascular surgeon or interventional radiologist accesses the circuit percutaneously, removes or dissolves thrombus, and uses a balloon to treat a stenosis in the peripheral portion of the circuit. Imaging and radiological supervision associated with the intervention are included. The service is commonly performed in a hospital or an outpatient vascular access setting when restoring access flow requires both clot treatment and angioplasty.
Select this code when thrombectomy or thrombolytic treatment and peripheral-segment balloon angioplasty are performed in the same dialysis circuit. Use a different code when the procedure lacks one of those elements or uses stenting instead of balloon angioplasty. The report should identify the treated access, thrombus treatment, angioplasty site, and relevant findings. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. In a session with multiple procedures, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; co-surgeons require 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 36905 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$2066.80 to $2290.90
| Payment locality | Office | Facility |
|---|---|---|
| Chicago, IL | $2,272.32 | $443.88 |
| East St. Louis, IL | $2,099.32 | $425.52 |
| Rest of Illinois | $2,066.80 | $405.74 |
| Suburban Chicago, IL | $2,290.90 | $422.43 |
How the 36905 rate is calculated
Each of 36905’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 · 36905
RVUs × geographic indexes × conversion factor
Work8.78
8.78 RVUs× 1.000 GPCI
Practice expense55.95
55.95 RVUs× 1.000 GPCI
Malpractice1.29
1.29 RVUs× 1.000 GPCI
Adjusted RVUs
66.0200
Conversion factor
$33.4009
Medicare rate
$2,205.13
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36905
The CMS indicators that decide how 36905 is paid alongside other services.
CMS payment indicators · 36905
Dialysis thrombectomy, peripheral balloon angioplasty
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
36905 without 51 · national office
$2,205.13
Dialysis thrombectomy, peripheral balloon angioplasty
36905-51 · Second procedure: 50%
$1,102.57
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%).
36905 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 36904Dialysis thrombectomyWithout peripheral angioplasty or stent
- 36904 covers dialysis-circuit thrombectomy or thrombolytic treatment without peripheral balloon angioplasty. Choose 36905 when that angioplasty is also performed.
- 36902Dialysis access angioplastyPeripheral segment
- 36902 covers peripheral balloon angioplasty without thrombectomy or thrombolytic treatment. When both clot treatment and peripheral angioplasty are performed, use 36905 rather than reporting both codes.
- 36906Dialysis access interventionCentral-segment angioplasty
- Both codes include thrombectomy or thrombolytic treatment, but 36906 is for peripheral-segment stent placement; 36905 is for balloon angioplasty there.
- 36907Dialysis angioplastyCentral segment
- 36907 is an add-on for central-segment balloon angioplasty, not the primary thrombectomy service. It may accompany 36905 when that separate central treatment is performed.
36905 billing questions
When is this code selected instead of 36904?
Use 36905 when thrombectomy or thrombolytic treatment is accompanied by balloon angioplasty in the peripheral dialysis-circuit segment. Code 36904 describes circuit thrombectomy without that peripheral angioplasty.
Can 36902 also be reported for the peripheral angioplasty?
No. The peripheral balloon angioplasty is included in 36905 when performed with the circuit thrombectomy or thrombolytic treatment.
How does 36905 differ from 36906?
Both include dialysis-circuit thrombectomy or thrombolytic treatment. Use 36905 when the peripheral lesion is treated with balloon angioplasty; 36906 represents peripheral-segment stent placement.
Can central-segment treatment be reported separately?
A separately performed central-segment balloon angioplasty may be reported with add-on code 36907. Central-segment stent placement is represented by add-on code 36908.
Should modifier 50 be appended for bilateral access treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What documentation supports reporting 36905?
Document the dialysis access treated, the thrombectomy or thrombolytic work, and the peripheral-segment stenosis treated with balloon angioplasty. Include the procedural findings and imaging that support those services.
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
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