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Billing code 36833: Fistula revisionMedicare rate & RVUs

Open revision of a hemodialysis arteriovenous fistula with clot removal, reported when the surgeon corrects access anatomy and performs thrombectomy in one operation.

CMS RVU26DEffective Oct 1, 2026109 payment localities3.1K Medicare services in 2024

Medicare pays $736.49 for 36833 nationally in a facility.

Medicare rate · 36833

Fistula revision

Swap in your local Medicare rate.

Work RVUs
14.14
Total RVUs
22.05
Global days
090

National rate · 2026

$736.49

Facility setting, before claim adjustments.

See every locality for 36833 → · 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 36833 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 36833 covers

A vascular surgeon uses this service to revise a hemodialysis arteriovenous fistula through open surgery while removing thrombus from the access. It fits an operation in which both clot removal and correction of the fistula are performed, such as addressing a thrombosed, dysfunctional dialysis access. The service is commonly performed in a hospital operating room or another surgical facility. It is distinct from an isolated open declot or a revision performed without thrombectomy.

The operative report should support both the open revision and thrombectomy; do not separately report the standalone thrombectomy or revision for the same work. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. 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 36833 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

36833 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$666.21
Alaska*Unavailable$927.83
ArizonaUnavailable$714.67
ArkansasUnavailable$657.76
AtlantaUnavailable$764.44
AustinUnavailable$732.02
BakersfieldUnavailable$712.11
Baltimore/Surr. CntysUnavailable$783.11
BeaumontUnavailable$715.00
BrazoriaUnavailable$712.45

36833 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
36833 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 36833 rate is calculated

Each of 36833’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 · 36833

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 14.14Practice expense 4.30Malpractice 3.61

22.0500 adjusted RVUs×$33.4009 conversion factor=$736.49

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

Payment rules and modifiers for 36833

36833 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 36833

Fistula revision

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 · 36833

Fistula revision

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

36833 without 51 · national facility

$736.49

Fistula revision

36833-51 · Second procedure: 50%

$368.25

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

36833 compared with similar codes

Compare codes

36833 vs 36831 vs 36832 vs 36902: national Medicare rates

Swap in your local Medicare rate.

  • 36833
    Fistula revision · 14.14 wRVU
    —
  • 36831
    Fistula thrombectomy · 10.73 wRVU
    —
  • 36832
    Fistula revision · 13.16 wRVU
    —
  • 36902
    Dialysis access angioplasty · 4.71 wRVU
    $1,190.74

How to choose

36831Fistula thrombectomy
36831 describes open thrombectomy of an AV fistula without the revision captured by 36833. Choose 36833 when the surgeon revises the fistula and removes thrombus in the same operation.
36832Fistula revision
36832 is open fistula revision without thrombectomy. Report 36833 when the operative service includes both revision and clot removal.
36902Dialysis access angioplasty
36902 is an endovascular dialysis-circuit angioplasty service. It differs from the open fistula revision with thrombectomy described by 36833.

Codes related to 36833

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

Codes related to 36833
CodeHow it relatesNational office range
Same family
36832Fistula revisionOpen fistula revision without thrombectomy.No office rate
Used instead
36831Fistula thrombectomyOpen thrombectomy for an AV fistula when revision is not part of the service.No office rate
36902Dialysis access angioplastyEndovascular angioplasty of a dialysis circuit rather than open revision with thrombectomy.$1,036.76–$1,643.03

36833 billing questions

How does this differ from 36832?

Use 36833 when the open fistula revision includes thrombectomy. Code 36832 describes open revision without thrombectomy.

Can 36831 also be reported for the clot removal?

Do not separately report 36831 for thrombectomy that is part of the same fistula revision operation. This code covers the combined revision and thrombectomy service.

What documentation supports reporting 36833?

The operative report should establish that the surgeon performed an open revision of the arteriovenous fistula and removed thrombus during that operation.

Can modifier 50 be used for bilateral fistulas?

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

How is this code affected by the global period?

It has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.

May an assistant or co-surgeon be reported?

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 36833PPRRVU2026_Oct_nonQPP.csv, line 4,555 (RVU26D)

Open CMS sourceHow we calculate rates

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