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Billing code 36830: AV graft creationMedicare rate & RVUs

Reports open creation of dialysis access by connecting an artery and vein with a graft made from material other than the patient’s own tissue.

CMS RVU26DEffective Oct 1, 2026109 payment localities12.4K Medicare services in 2024

Medicare pays $607.23 for 36830 nationally in a facility.

Medicare rate · 36830

AV graft creation

Swap in your local Medicare rate.

Work RVUs
11.73
Total RVUs
18.18
Global days
090

National rate · 2026

$607.23

Facility setting, before claim adjustments.

See every locality for 36830 → · 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 36830 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 36830 covers

A vascular surgeon creates an arteriovenous access by placing a nonautologous graft between an artery and a vein, then connecting the graft to both vessels. This approach is used for hemodialysis access when a direct connection between the patient’s own artery and vein is not the selected method. The access is commonly created in an arm, and the graft may be synthetic or biologic material from another source. The service is generally performed in an operating room or other surgical facility.

Report this code when the operative record supports open graft placement and arterial and venous connections using nonautologous material. Documentation should identify the graft material and the vessels or sites joined; a direct native-vessel fistula or a graft made from the patient’s own vein is coded differently. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. 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 36830 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

36830 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$549.34
Alaska*Unavailable$765.62
ArizonaUnavailable$589.23
ArkansasUnavailable$542.38
AtlantaUnavailable$630.39
AustinUnavailable$603.27
BakersfieldUnavailable$586.56
Baltimore/Surr. CntysUnavailable$645.66
BeaumontUnavailable$589.74
BrazoriaUnavailable$587.28

36830 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
36830 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 36830 rate is calculated

Each of 36830’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 · 36830

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 11.73Practice expense 3.45Malpractice 3.00

18.1800 adjusted RVUs×$33.4009 conversion factor=$607.23

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

Payment rules and modifiers for 36830

36830 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 36830

AV graft creation

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 · 36830

AV graft creation

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

36830 without 51 · national facility

$607.23

AV graft creation

36830-51 · Second procedure: 50%

$303.62

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

36830 compared with similar codes

Compare codes

36830 vs 36825 vs 36821 vs 36818 vs 36831: national Medicare rates

Swap in your local Medicare rate.

  • 36830
    AV graft creation · 11.73 wRVU
    —
  • 36825
    Dialysis access · 13.82 wRVU
    —
  • 36821
    Dialysis access · 11.6 wRVU
    —
  • 36818
    AV fistula creation · 12.08 wRVU
    —
  • 36831
    Fistula thrombectomy · 10.73 wRVU
    —

How to choose

36825Dialysis access
Choose 36830 for access made with nonautologous graft material. Choose 36825 when the graft is harvested from the patient.
36821Dialysis access
Code 36821 describes a direct artery-to-vein connection. Code 36830 involves an interposed nonautologous graft.
36818AV fistula creation
Code 36818 is a direct upper-arm connection involving the cephalic vein. Code 36830 is selected when nonautologous graft material bridges the vessels.
36831Fistula thrombectomy
Code 36831 is for open thrombectomy of an existing arteriovenous fistula. Code 36830 creates access with a nonautologous graft.

Codes related to 36830

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

Codes related to 36830
CodeHow it relatesNational office range
Same family
36825Dialysis accessGraft-based access using the patient’s own tissue rather than nonautologous material.No office rate
Used instead
36821Dialysis accessDirect artery-to-vein access without an interposed graft.No office rate
36818AV fistula creationDirect upper-arm access using the cephalic vein rather than a nonautologous graft.No office rate
36819Dialysis accessDirect upper-arm access using the basilic vein rather than a nonautologous graft.No office rate
36820AV fistulaDirect forearm access using a vein rather than a nonautologous graft.No office rate

36830 billing questions

How is this code different from 36825?

This code represents access created with nonautologous graft material. Code 36825 is for a graft made from the patient’s own tissue, such as a harvested vein.

When would a direct fistula code be used instead?

Use a direct fistula code when the surgeon connects the patient’s artery and vein without inserting a graft. The operative description should show whether graft material bridges the vessels.

What documentation supports reporting this service?

The operative report should establish open access creation, the nonautologous graft material, and the artery and vein connected. Include the anatomic sites and describe the graft connections.

Does the 90-day global period include access follow-up?

It includes the day-before preoperative visit and 90 days of related postoperative care. Care related to this access during that period is part of the global service.

Can modifier 50 be used for access created on both sides?

CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate. The code’s descriptor or anatomy supports that treatment.

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.

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 36830PPRRVU2026_Oct_nonQPP.csv, line 4,552 (RVU26D)

Open CMS sourceHow we calculate rates

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