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CPT code 36861: Cannula declotting2026 Medicare rate & RVUs

Declotting an internal arteriovenous dialysis cannula to restore access flow when treatment is directed at the cannula rather than open fistula thrombectomy.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $123.58 for 36861 nationally in a facility.

Medicare rate · 36861

Cannula declotting

Office or facility?

Work RVUs
2.46
Total RVUs
3.70
Global days
000

National rate · 2026

$123.58

Facility setting, before claim adjustments.

See every locality for 36861 →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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 36861 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 36861 covers

This service removes obstructing clot from an internal arteriovenous cannula used for hemodialysis, with the goal of restoring flow through the access. A vascular surgeon or another physician who manages dialysis access may perform it when the problem is the cannula itself. It is distinct from open thrombectomy of the arteriovenous fistula and from declotting an external cannula.

Report the code when the documentation identifies an internal dialysis cannula and describes the clot removal performed. A 0-day global period includes same-day preoperative and postoperative care. 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. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery 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 36861 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

36861 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$111.70
AlaskaUnavailable$156.20
ArizonaUnavailable$119.85
ArkansasUnavailable$110.28
Atlanta, GAUnavailable$128.51
Austin, TXUnavailable$122.42
Bakersfield, CAUnavailable$118.55
Baltimore area, MDUnavailable$131.48
Beaumont, TXUnavailable$120.27
Brazoria, TXUnavailable$119.29

36861 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
36861 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 36861 rate is calculated

Each of 36861’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 · 36861

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.46

2.46 RVUs× 1.000 GPCI

Practice expense0.59

0.59 RVUs× 1.000 GPCI

Malpractice0.65

0.65 RVUs× 1.000 GPCI

Adjusted RVUs

3.7000

Conversion factor

$33.4009

Medicare rate

$123.58

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

Payment rules and modifiers for 36861

The CMS indicators that decide how 36861 is paid alongside other services.

CMS payment indicators · 36861

Cannula declotting

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

36861 without 51 · national facility

$123.58

Cannula declotting

36861-51 · Second procedure: 50%

$61.79

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

36861 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 36861

    Cannula declotting2.46 wRVU

    Not priced

  • 36860

    Cannula declotting1.96 wRVU

    $258.19

  • 36831

    Fistula thrombectomy10.73 wRVU

    Not priced

  • 36904

    Dialysis thrombectomy7.31 wRVU

    $1,740.85

How to choose

36860Cannula declotting
Choose 36860 for declotting an external arteriovenous cannula; 36861 describes an internal cannula.
36831Fistula thrombectomy
36831 describes open thrombectomy of an arteriovenous fistula. Use 36861 when the documented treatment is directed at the internal cannula.
36904Dialysis thrombectomy
36904 describes percutaneous transluminal thrombectomy of a dialysis circuit. This code describes declotting an internal cannula, not an endovascular circuit thrombectomy.

Codes related to 36861

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

Codes related to 36861
CodeHow it relatesNational office range
Same family
36860Cannula declottingDeclotting code for an external rather than internal arteriovenous cannula.$225.16–$335.14
Used instead
36831Fistula thrombectomyOpen thrombectomy of the arteriovenous fistula rather than cannula-focused declotting.No office rate
36904Dialysis thrombectomyPercutaneous transluminal thrombectomy of a dialysis circuit using an endovascular approach.$1,516.84–$2,395.06

36861 billing questions

How is this different from 36860?

This code describes declotting an internal arteriovenous cannula. Code 36860 is for an external cannula.

When would 36831 be more appropriate?

Use 36831 for open thrombectomy of an arteriovenous fistula. This code is for clot removal directed at the internal cannula.

Can modifier 50 be reported?

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

What documentation supports reporting this code?

Document that the cannula is internal, that clot obstructed it, and that the service involved removal of that clot. Distinguish cannula declotting from open fistula thrombectomy.

How does Medicare handle other procedures performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Same-day preoperative and postoperative care is included in this code's 0-day global period.

Can an assistant or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery 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 36861PPRRVU2026_Oct_nonQPP.csv, line 4,561 (RVU26D)

Open CMS sourceHow we calculate rates

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