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CMS RVU26D · Effective 2026-10-01

36831 in Merced

Office / nonfacility

Not available in this setting

Base rate per service

Facility setting

$540.38

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Vascular access surgery

About 36831: Open arteriovenous fistula thrombectomy

Open removal of thrombus from a hemodialysis arteriovenous fistula without revising the access when clot obstructs fistula flow.

This service removes obstructing clot from a surgically created arteriovenous fistula through open surgical exposure, with the goal of restoring access flow. Vascular surgeons and other surgeons who manage dialysis access typically perform it in an operating room when a fistula has thrombosed. The code describes thrombectomy without revision of the fistula; it is not for declotting a cannula or treating a graft as though it were a fistula.

Report the code when the operative record supports open clot removal from the fistula and no access revision is performed. Document the access site, open approach, thrombus removal, and whether the fistula was revised; when thrombectomy accompanies revision, consider 36833 instead. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

CMS billing rules for 36831

Global period
Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Assistant at surgery may be paid.
Co-surgeons
Co-surgeons paid only with supporting documentation.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU10.73 · 63%
  • Practice expense (office) RVU3.46 · 20%
  • Malpractice RVU2.75 · 16%

2K

Medicare services in 2024 · #2447 by national volume

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.

36831 compared with similar codes

Office rates for Merced, from the same CMS release.

36832

Fistula revision

Open, without thrombectomy

No office rate

36832 describes open fistula revision without thrombectomy. Choose 36831 when open clot removal is performed without revising the access.

36833

Fistula revision

Open, with thrombectomy

No office rate

36833 applies when open fistula revision and thrombectomy are both performed. 36831 is for thrombectomy without revision.

36860

Cannula declotting

External cannula, no revision

$268.26

36860 concerns declotting an external dialysis cannula. 36831 is for open removal of thrombus from the fistula itself.

36861

Cannula declotting

Internal cannula

No office rate

36861 is a cannula-declotting service, while 36831 addresses open thrombectomy of the arteriovenous fistula.

The same code, a different location

How does Merced compare?

36831 across payment areas

Same release and payment basis · bars start at $0

  1. Merced · This locality

    Unavailable

  2. Bakersfield

    Unavailable

    No comparable rate is available in this setting.

  3. Chico

    Unavailable

    No comparable rate is available in this setting.

  4. El Centro

    Unavailable

    No comparable rate is available in this setting.

  5. Fresno

    Unavailable

    No comparable rate is available in this setting.

  6. Hanford-Corcoran

    Unavailable

    No comparable rate is available in this setting.

  7. No comparable rate is available in this setting.

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas
  • Madera

    California · 36831

    Office

    Unavailable

    Facility

    $540.38

    No comparable office rate is available.

  • Modesto

    California · 36831

    Office

    Unavailable

    Facility

    $540.38

    No comparable office rate is available.

  • Napa

    California · 36831

    Office

    Unavailable

    Facility

    $579.95

    No comparable office rate is available.

  • Oxnard-Thousand Oaks-Ventura

    California · 36831

    Office

    Unavailable

    Facility

    $562.25

    No comparable office rate is available.

  • Redding

    California · 36831

    Office

    Unavailable

    Facility

    $540.38

    No comparable office rate is available.

  • Rest Of California

    California · 36831

    Office

    Unavailable

    Facility

    $540.38

    No comparable office rate is available.

  • Riverside-San Bernardino-Ontario

    California · 36831

    Office

    Unavailable

    Facility

    $569.85

    No comparable office rate is available.

  • Sacramento-Roseville-Folsom

    California · 36831

    Office

    Unavailable

    Facility

    $554.93

    No comparable office rate is available.

  • Salinas

    California · 36831

    Office

    Unavailable

    Facility

    $552.68

    No comparable office rate is available.

  • San Diego-Chula Vista-Carlsbad

    California · 36831

    Office

    Unavailable

    Facility

    $557.15

    No comparable office rate is available.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 36831

    Office

    Unavailable

    Facility

    $597.55

    No comparable office rate is available.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 36831

    Office

    Unavailable

    Facility

    $594.43

    No comparable office rate is available.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 36831

    Office

    Unavailable

    Facility

    $613.70

    No comparable office rate is available.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 36831

    Office

    Unavailable

    Facility

    $600.93

    No comparable office rate is available.

  • San Luis Obispo-Paso Robles

    California · 36831

    Office

    Unavailable

    Facility

    $545.35

    No comparable office rate is available.

  • Santa Cruz-Watsonville

    California · 36831

    Office

    Unavailable

    Facility

    $555.56

    No comparable office rate is available.

  • Santa Maria-Santa Barbara

    California · 36831

    Office

    Unavailable

    Facility

    $552.41

    No comparable office rate is available.

  • Santa Rosa-Petaluma

    California · 36831

    Office

    Unavailable

    Facility

    $560.29

    No comparable office rate is available.

  • Stockton

    California · 36831

    Office

    Unavailable

    Facility

    $540.38

    No comparable office rate is available.

  • Vallejo

    California · 36831

    Office

    Unavailable

    Facility

    $575.45

    No comparable office rate is available.

  • Visalia

    California · 36831

    Office

    Unavailable

    Facility

    $540.38

    No comparable office rate is available.

  • Yuba City

    California · 36831

    Office

    Unavailable

    Facility

    $540.38

    No comparable office rate is available.

  • Dc + Md/Va Suburbs

    District of Columbia · 36831

    Office

    Unavailable

    Facility

    $616.11

    No comparable office rate is available.

  • Miami

    Florida · 36831

    Office

    Unavailable

    Facility

    $710.99

    No comparable office rate is available.

  • Chicago

    Illinois · 36831

    Office

    Unavailable

    Facility

    $687.85

    No comparable office rate is available.

  • Manhattan

    New York · 36831

    Office

    Unavailable

    Facility

    $661.30

    No comparable office rate is available.

  • Alaska*

    Alaska · 36831

    Office

    Unavailable

    Facility

    $711.28

    No comparable office rate is available.

  • Alabama

    Alabama · 36831

    Office

    Unavailable

    Facility

    $511.50

    No comparable office rate is available.

  • Arkansas

    Arkansas · 36831

    Office

    Unavailable

    Facility

    $504.97

    No comparable office rate is available.

  • Arizona

    Arizona · 36831

    Office

    Unavailable

    Facility

    $549.00

    No comparable office rate is available.

  • Colorado

    Colorado · 36831

    Office

    Unavailable

    Facility

    $557.39

    No comparable office rate is available.

  • Connecticut

    Connecticut · 36831

    Office

    Unavailable

    Facility

    $601.17

    No comparable office rate is available.

  • Delaware

    Delaware · 36831

    Office

    Unavailable

    Facility

    $556.94

    No comparable office rate is available.

  • Fort Lauderdale

    Florida · 36831

    Office

    Unavailable

    Facility

    $641.53

    No comparable office rate is available.

  • Rest Of Florida

    Florida · 36831

    Office

    Unavailable

    Facility

    $606.93

    No comparable office rate is available.

  • Atlanta

    Georgia · 36831

    Office

    Unavailable

    Facility

    $587.20

    No comparable office rate is available.

  • Rest Of Georgia

    Georgia · 36831

    Office

    Unavailable

    Facility

    $570.97

    No comparable office rate is available.

  • Hawaii, Guam

    Hawaii · 36831

    Office

    Unavailable

    Facility

    $542.97

    No comparable office rate is available.

  • Iowa

    Iowa · 36831

    Office

    Unavailable

    Facility

    $500.60

    No comparable office rate is available.

  • Idaho

    Idaho · 36831

    Office

    Unavailable

    Facility

    $508.16

    No comparable office rate is available.

  • East St. Louis

    Illinois · 36831

    Office

    Unavailable

    Facility

    $649.70

    No comparable office rate is available.

  • Rest Of Illinois

    Illinois · 36831

    Office

    Unavailable

    Facility

    $607.47

    No comparable office rate is available.

  • Suburban Chicago

    Illinois · 36831

    Office

    Unavailable

    Facility

    $642.35

    No comparable office rate is available.

  • Indiana

    Indiana · 36831

    Office

    Unavailable

    Facility

    $510.16

    No comparable office rate is available.

  • Kansas

    Kansas · 36831

    Office

    Unavailable

    Facility

    $509.16

    No comparable office rate is available.

  • Kentucky

    Kentucky · 36831

    Office

    Unavailable

    Facility

    $545.18

    No comparable office rate is available.

  • New Orleans

    Louisiana · 36831

    Office

    Unavailable

    Facility

    $571.48

    No comparable office rate is available.

  • Rest Of Louisiana

    Louisiana · 36831

    Office

    Unavailable

    Facility

    $548.66

    No comparable office rate is available.

  • Metropolitan Boston

    Massachusetts · 36831

    Office

    Unavailable

    Facility

    $592.82

    No comparable office rate is available.

  • Rest Of Massachusetts

    Massachusetts · 36831

    Office

    Unavailable

    Facility

    $559.02

    No comparable office rate is available.

  • Baltimore/Surr. Cntys

    Maryland · 36831

    Office

    Unavailable

    Facility

    $601.75

    No comparable office rate is available.

  • Rest Of Maryland

    Maryland · 36831

    Office

    Unavailable

    Facility

    $563.25

    No comparable office rate is available.

  • Rest Of Maine

    Maine · 36831

    Office

    Unavailable

    Facility

    $521.85

    No comparable office rate is available.

  • Southern Maine

    Maine · 36831

    Office

    Unavailable

    Facility

    $530.88

    No comparable office rate is available.

  • Detroit

    Michigan · 36831

    Office

    Unavailable

    Facility

    $624.78

    No comparable office rate is available.

  • Rest Of Michigan

    Michigan · 36831

    Office

    Unavailable

    Facility

    $567.61

    No comparable office rate is available.

  • Minnesota

    Minnesota · 36831

    Office

    Unavailable

    Facility

    $504.50

    No comparable office rate is available.

  • Metropolitan Kansas City

    Missouri · 36831

    Office

    Unavailable

    Facility

    $556.65

    No comparable office rate is available.

  • Metropolitan St. Louis

    Missouri · 36831

    Office

    Unavailable

    Facility

    $560.45

    No comparable office rate is available.

  • Rest Of Missouri

    Missouri · 36831

    Office

    Unavailable

    Facility

    $547.47

    No comparable office rate is available.

  • Mississippi

    Mississippi · 36831

    Office

    Unavailable

    Facility

    $525.77

    No comparable office rate is available.

  • Montana**

    Montana · 36831

    Office

    Unavailable

    Facility

    $565.63

    No comparable office rate is available.

  • North Carolina

    North Carolina · 36831

    Office

    Unavailable

    Facility

    $524.91

    No comparable office rate is available.

  • North Dakota**

    North Dakota · 36831

    Office

    Unavailable

    Facility

    $511.25

    No comparable office rate is available.

  • Nebraska

    Nebraska · 36831

    Office

    Unavailable

    Facility

    $499.78

    No comparable office rate is available.

  • New Hampshire

    New Hampshire · 36831

    Office

    Unavailable

    Facility

    $559.07

    No comparable office rate is available.

  • Northern Nj

    New Jersey · 36831

    Office

    Unavailable

    Facility

    $613.13

    No comparable office rate is available.

  • Rest Of New Jersey

    New Jersey · 36831

    Office

    Unavailable

    Facility

    $599.69

    No comparable office rate is available.

  • New Mexico

    New Mexico · 36831

    Office

    Unavailable

    Facility

    $574.68

    No comparable office rate is available.

  • Nevada**

    Nevada · 36831

    Office

    Unavailable

    Facility

    $550.59

    No comparable office rate is available.

  • Nyc Suburbs/Long Island

    New York · 36831

    Office

    Unavailable

    Facility

    $689.31

    No comparable office rate is available.

  • Poughkpsie/N Nyc Suburbs

    New York · 36831

    Office

    Unavailable

    Facility

    $612.21

    No comparable office rate is available.

  • Queens

    New York · 36831

    Office

    Unavailable

    Facility

    $650.38

    No comparable office rate is available.

  • Rest Of New York

    New York · 36831

    Office

    Unavailable

    Facility

    $532.75

    No comparable office rate is available.

  • Ohio

    Ohio · 36831

    Office

    Unavailable

    Facility

    $556.49

    No comparable office rate is available.

  • Oklahoma

    Oklahoma · 36831

    Office

    Unavailable

    Facility

    $532.96

    No comparable office rate is available.

  • Portland

    Oregon · 36831

    Office

    Unavailable

    Facility

    $560.86

    No comparable office rate is available.

  • Rest Of Oregon

    Oregon · 36831

    Office

    Unavailable

    Facility

    $538.07

    No comparable office rate is available.

  • Metropolitan Philadelphia

    Pennsylvania · 36831

    Office

    Unavailable

    Facility

    $594.73

    No comparable office rate is available.

  • Rest Of Pennsylvania

    Pennsylvania · 36831

    Office

    Unavailable

    Facility

    $551.28

    No comparable office rate is available.

  • Puerto Rico

    Puerto Rico · 36831

    Office

    Unavailable

    Facility

    $565.70

    No comparable office rate is available.

  • Rhode Island

    Rhode Island · 36831

    Office

    Unavailable

    Facility

    $566.51

    No comparable office rate is available.

  • South Carolina

    South Carolina · 36831

    Office

    Unavailable

    Facility

    $543.25

    No comparable office rate is available.

  • South Dakota**

    South Dakota · 36831

    Office

    Unavailable

    Facility

    $504.82

    No comparable office rate is available.

  • Tennessee

    Tennessee · 36831

    Office

    Unavailable

    Facility

    $512.77

    No comparable office rate is available.

  • Austin

    Texas · 36831

    Office

    Unavailable

    Facility

    $562.76

    No comparable office rate is available.

  • Beaumont

    Texas · 36831

    Office

    Unavailable

    Facility

    $548.89

    No comparable office rate is available.

  • Brazoria

    Texas · 36831

    Office

    Unavailable

    Facility

    $547.43

    No comparable office rate is available.

  • Dallas

    Texas · 36831

    Office

    Unavailable

    Facility

    $555.53

    No comparable office rate is available.

  • Fort Worth

    Texas · 36831

    Office

    Unavailable

    Facility

    $555.57

    No comparable office rate is available.

  • Galveston

    Texas · 36831

    Office

    Unavailable

    Facility

    $552.07

    No comparable office rate is available.

  • Houston

    Texas · 36831

    Office

    Unavailable

    Facility

    $602.41

    No comparable office rate is available.

  • Rest Of Texas

    Texas · 36831

    Office

    Unavailable

    Facility

    $551.01

    No comparable office rate is available.

  • Utah

    Utah · 36831

    Office

    Unavailable

    Facility

    $549.51

    No comparable office rate is available.

  • Virginia

    Virginia · 36831

    Office

    Unavailable

    Facility

    $536.84

    No comparable office rate is available.

  • Virgin Islands

    United States Virgin Islands · 36831

    Office

    Unavailable

    Facility

    $565.70

    No comparable office rate is available.

  • Vermont

    Vermont · 36831

    Office

    Unavailable

    Facility

    $519.28

    No comparable office rate is available.

  • Rest Of Washington

    Washington · 36831

    Office

    Unavailable

    Facility

    $554.64

    No comparable office rate is available.

  • Seattle (King Cnty)

    Washington · 36831

    Office

    Unavailable

    Facility

    $593.16

    No comparable office rate is available.

  • Wisconsin

    Wisconsin · 36831

    Office

    Unavailable

    Facility

    $497.40

    No comparable office rate is available.

  • West Virginia

    West Virginia · 36831

    Office

    Unavailable

    Facility

    $590.26

    No comparable office rate is available.

  • Wyoming**

    Wyoming · 36831

    Office

    Unavailable

    Facility

    $541.93

    No comparable office rate is available.

See how rates vary across the country

36831 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View all state and territory rates as a table
State / territoryRate 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

Explore 36831 on the national rate map →

Where does this rate apply?

Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 36831 in Merced. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$594.42

$540.38 × 110% = $594.42

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 36831 in Merced.

PPRRVU2026_Oct_nonQPP.csv

4,553

Code
36831
Physician work
10.73
Practice expense
3.46
Malpractice
2.75

GPCI2026.csv

15

Locality
Merced
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Facility calculation for 36831 in Merced
ComponentRVULocality factorAdjusted
Physician work10.73× 1.01710.9124
Practice expense3.46× 1.0963.7922
Malpractice2.75× 0.5361.4740
Total RVUs16.1786
Conversion factor× 33.4009

Facility rate, Merced$540.38

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 36831 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work10.731.017
Practice expense3.461.096
Malpractice2.750.536

(10.73 × 1.017 + 3.46 × 1.096 + 2.75 × 0.536) × $33.4009 = $540.38

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

36831 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01Not available in this setting$540.38RVU26D
2026-07-01Not available in this setting$540.38RVU26C
2026-04-01Not available in this setting$540.38RVU26B
2026-01-01Not available in this setting$540.38RVU26A
2025-10-01Not available in this setting$568.63RVU25D
2025-07-01Not available in this setting$568.63RVU25C
2025-04-01Not available in this setting$568.63RVU25B
2025-01-01Not available in this setting$568.63RVU25A

36831 billing questions

When should 36831 be chosen over 36833?

Use 36831 for open fistula thrombectomy without revision. When the surgeon revises the fistula and removes thrombus during the procedure, 36833 describes that combination.

Can 36831 be reported for declotting a dialysis cannula?

No. This code concerns open thrombectomy of the arteriovenous fistula itself; codes 36860 and 36861 concern cannula declotting.

What documentation supports reporting 36831?

The operative report should identify the fistula, describe open exposure and removal of thrombus, and clarify whether revision was performed.

Does modifier 50 apply when fistulas are treated on both sides?

CMS identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50.

How does the 90-day global period affect postoperative reporting?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 36831PPRRVU2026_Oct_nonQPP.csv, line 4,553 (RVU26D)
Geographic factors for MercedGPCI2026.csv, line 15 (RVU26D)