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Billing code 36823: Cannula insertionMedicare rate & RVUs

Reports surgical insertion of cannulae for hemodialysis when the documented service matches this cannula-insertion code rather than access creation.

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

Medicare pays $1,317.00 for 36823 nationally in a facility.

Medicare rate · 36823

Cannula insertion

Swap in your local Medicare rate.

Work RVUs
22.41
Total RVUs
39.43
Global days
090

National rate · 2026

$1,317.00

Facility setting, before claim adjustments.

See every locality for 36823 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 36823 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 36823 covers

This service covers operative insertion of cannulae for hemodialysis. It is generally performed by a vascular or other access surgeon in a hospital or similar surgical setting. The operative report should identify the cannulae inserted and describe the procedure and vascular access involved; do not infer a particular access configuration from the abbreviated CMS descriptor alone.

Select 36823 only when the full code descriptor and operative details support it, rather than a neighboring cannula-insertion code or a code for creating an arteriovenous fistula or graft. Documentation should make the procedure performed clear enough to distinguish insertion from access construction. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and 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.

Where 36823 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

36823 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,184.01
Alaska*Unavailable$1,625.20
ArizonaUnavailable$1,276.73
ArkansasUnavailable$1,167.90
AtlantaUnavailable$1,365.41
AustinUnavailable$1,317.00
BakersfieldUnavailable$1,288.20
Baltimore/Surr. CntysUnavailable$1,403.34
BeaumontUnavailable$1,269.64
BrazoriaUnavailable$1,275.58

36823 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
36823 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 36823 rate is calculated

Each of 36823’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 · 36823

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 22.41Practice expense 11.02Malpractice 6.00

39.4300 adjusted RVUs×$33.4009 conversion factor=$1,317.00

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 36823

36823 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 36823

Cannula insertion

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)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
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 · 36823

Cannula insertion

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

36823 without 51 · national facility

$1,317.00

Cannula insertion

36823-51 · Second procedure: 50%

$658.50

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

36823 compared with similar codes

Compare codes

36823 vs 36821 vs 36825 vs 36835: national Medicare rates

Swap in your local Medicare rate.

  • 36823
    Cannula insertion · 22.41 wRVU
    —
  • 36821
    Dialysis access · 11.6 wRVU
    —
  • 36825
    Dialysis access · 13.82 wRVU
    —
  • 36835
    Dialysis access · 7.32 wRVU
    —

How to choose

36821Dialysis access
36823 reports cannula insertion. Use 36821 when the surgeon creates a direct arteriovenous fistula.
36825Dialysis access
36825 describes creation of an arteriovenous access using an autograft; 36823 is for cannula insertion.
36835Dialysis access
36835 describes insertion of a Thomas shunt. Do not substitute it for 36823 unless the operative service matches the shunt procedure.

Codes related to 36823

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

Codes related to 36823
CodeHow it relatesNational office range
Same family
36800Cannula insertionNeighboring cannula-insertion code; compare its full descriptor with the operative details.No office rate
36810Dialysis cannulaRelated cannula-insertion code; select according to the service described in the full descriptor.No office rate
36815Dialysis cannulaRelated cannula-insertion code; verify the documented procedure against its full descriptor.No office rate
Used instead
36821Dialysis accessDescribes direct arteriovenous fistula creation rather than cannula insertion.No office rate
36825Dialysis accessDescribes arteriovenous access creation using an autograft, not cannula insertion.No office rate

36823 billing questions

How do I distinguish 36823 from the neighboring cannula-insertion codes?

Use the full code descriptors and the operative report to match the specific cannula-insertion service performed. The abbreviated CMS descriptor alone does not establish the configuration.

Is 36823 an access-creation code?

No. It describes cannula insertion; codes such as 36821 and 36825 describe creation of an arteriovenous access.

Can modifier 50 be reported?

No. The CMS bilateral adjustment does not apply to 36823, and modifier 50 is inappropriate.

What postoperative care is included?

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

Can an assistant or co-surgeon be billed?

Assistant-at-surgery payment is restricted. Co-surgeon and team-surgery billing are not permitted for this code.

How are other procedures in the same session paid?

Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction.

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 36823PPRRVU2026_Oct_nonQPP.csv, line 4,550 (RVU26D)

Open CMS sourceHow we calculate rates

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