No office rate
Use 36800 for cannula insertion in a vein-to-vein configuration. This code identifies insertion in an internal AV fistula.
On this page
CMS RVU26D · Effective 2026-10-01
36815 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$117.69
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
About 36815: Cannula insertion in internal AV fistula
Reports surgical placement of a cannula in an internal arteriovenous fistula for hemodialysis or another intended purpose.
This service involves operative placement of a cannula in an internal arteriovenous fistula, the surgically connected artery and vein used for vascular access. A vascular surgeon or another qualified surgeon may perform it in an operating room or other procedural setting. It identifies cannula placement in an internal fistula, rather than creation of the fistula itself or placement in an external shunt.
Report the code when the documented procedure is cannula insertion into the internal AV fistula. The operative note should identify the access type and describe the cannula placement. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur 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 services are not paid, and co-surgeons and team surgery are not permitted.
CMS billing rules for 36815
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.55 · 69%
- Practice expense (office) RVU0.50 · 14%
- Malpractice RVU0.64 · 17%
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.
36815 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
No office rate
Use 36810 for the external shunt configuration; this code concerns cannula placement in an internal fistula.
No office rate
Code 36821 describes creation of a direct AV fistula. This code describes cannula insertion in an internal fistula.
The same code, a different location
How does Wyoming** compare?
36815 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming 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
Alabama
Alabama · 36815
Office
Unavailable
Facility
$111.88
No comparable office rate is available.
Arkansas
Arkansas · 36815
Office
Unavailable
Facility
$110.53
No comparable office rate is available.
Arizona
Arizona · 36815
Office
Unavailable
Facility
$119.65
No comparable office rate is available.
Bakersfield
California · 36815
Office
Unavailable
Facility
$118.11
No comparable office rate is available.
Chico
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
El Centro
California · 36815
Office
Unavailable
Facility
$116.49
No comparable office rate is available.
Fresno
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
Hanford-Corcoran
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
Madera
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
Merced
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
Modesto
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
Napa
California · 36815
Office
Unavailable
Facility
$123.41
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 36815
Office
Unavailable
Facility
$120.61
No comparable office rate is available.
Redding
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
Rest Of California
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 36815
Office
Unavailable
Facility
$123.24
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 36815
Office
Unavailable
Facility
$119.12
No comparable office rate is available.
Salinas
California · 36815
Office
Unavailable
Facility
$118.63
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 36815
Office
Unavailable
Facility
$119.29
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 36815
Office
Unavailable
Facility
$126.62
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 36815
Office
Unavailable
Facility
$125.90
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 36815
Office
Unavailable
Facility
$130.08
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 36815
Office
Unavailable
Facility
$127.11
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 36815
Office
Unavailable
Facility
$117.10
No comparable office rate is available.
Santa Cruz-Watsonville
California · 36815
Office
Unavailable
Facility
$118.71
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 36815
Office
Unavailable
Facility
$118.49
No comparable office rate is available.
Santa Rosa-Petaluma
California · 36815
Office
Unavailable
Facility
$119.69
No comparable office rate is available.
Stockton
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
Vallejo
California · 36815
Office
Unavailable
Facility
$122.36
No comparable office rate is available.
Visalia
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
Yuba City
California · 36815
Office
Unavailable
Facility
$116.38
No comparable office rate is available.
Colorado
Colorado · 36815
Office
Unavailable
Facility
$120.66
No comparable office rate is available.
Connecticut
Connecticut · 36815
Office
Unavailable
Facility
$130.73
No comparable office rate is available.
Delaware
Delaware · 36815
Office
Unavailable
Facility
$121.32
No comparable office rate is available.
Fort Lauderdale
Florida · 36815
Office
Unavailable
Facility
$140.74
No comparable office rate is available.
Rest Of Florida
Florida · 36815
Office
Unavailable
Facility
$133.27
No comparable office rate is available.
Atlanta
Georgia · 36815
Office
Unavailable
Facility
$128.07
No comparable office rate is available.
Rest Of Georgia
Georgia · 36815
Office
Unavailable
Facility
$125.55
No comparable office rate is available.
Hawaii, Guam
Hawaii · 36815
Office
Unavailable
Facility
$116.54
No comparable office rate is available.
Iowa
Iowa · 36815
Office
Unavailable
Facility
$108.94
No comparable office rate is available.
Idaho
Idaho · 36815
Office
Unavailable
Facility
$110.65
No comparable office rate is available.
East St. Louis
Illinois · 36815
Office
Unavailable
Facility
$143.59
No comparable office rate is available.
Rest Of Illinois
Illinois · 36815
Office
Unavailable
Facility
$133.83
No comparable office rate is available.
Suburban Chicago
Illinois · 36815
Office
Unavailable
Facility
$140.80
No comparable office rate is available.
Indiana
Indiana · 36815
Office
Unavailable
Facility
$111.04
No comparable office rate is available.
Kansas
Kansas · 36815
Office
Unavailable
Facility
$111.04
No comparable office rate is available.
Kentucky
Kentucky · 36815
Office
Unavailable
Facility
$119.58
No comparable office rate is available.
New Orleans
Louisiana · 36815
Office
Unavailable
Facility
$125.17
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 36815
Office
Unavailable
Facility
$120.43
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 36815
Office
Unavailable
Facility
$127.63
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 36815
Office
Unavailable
Facility
$121.16
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 36815
Office
Unavailable
Facility
$130.90
No comparable office rate is available.
Rest Of Maryland
Maryland · 36815
Office
Unavailable
Facility
$122.55
No comparable office rate is available.
Rest Of Maine
Maine · 36815
Office
Unavailable
Facility
$113.83
No comparable office rate is available.
Southern Maine
Maine · 36815
Office
Unavailable
Facility
$115.21
No comparable office rate is available.
Detroit
Michigan · 36815
Office
Unavailable
Facility
$137.33
No comparable office rate is available.
Rest Of Michigan
Michigan · 36815
Office
Unavailable
Facility
$124.55
No comparable office rate is available.
Minnesota
Minnesota · 36815
Office
Unavailable
Facility
$108.68
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 36815
Office
Unavailable
Facility
$121.74
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 36815
Office
Unavailable
Facility
$122.49
No comparable office rate is available.
Rest Of Missouri
Missouri · 36815
Office
Unavailable
Facility
$120.39
No comparable office rate is available.
Mississippi
Mississippi · 36815
Office
Unavailable
Facility
$115.35
No comparable office rate is available.
Montana**
Montana · 36815
Office
Unavailable
Facility
$123.21
No comparable office rate is available.
North Carolina
North Carolina · 36815
Office
Unavailable
Facility
$114.41
No comparable office rate is available.
North Dakota**
North Dakota · 36815
Office
Unavailable
Facility
$110.55
No comparable office rate is available.
Nebraska
Nebraska · 36815
Office
Unavailable
Facility
$108.67
No comparable office rate is available.
New Hampshire
New Hampshire · 36815
Office
Unavailable
Facility
$121.26
No comparable office rate is available.
Northern Nj
New Jersey · 36815
Office
Unavailable
Facility
$132.74
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 36815
Office
Unavailable
Facility
$130.27
No comparable office rate is available.
New Mexico
New Mexico · 36815
Office
Unavailable
Facility
$126.16
No comparable office rate is available.
Nevada**
Nevada · 36815
Office
Unavailable
Facility
$119.70
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 36815
Office
Unavailable
Facility
$150.18
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 36815
Office
Unavailable
Facility
$133.16
No comparable office rate is available.
Queens
New York · 36815
Office
Unavailable
Facility
$141.19
No comparable office rate is available.
Rest Of New York
New York · 36815
Office
Unavailable
Facility
$116.07
No comparable office rate is available.
Ohio
Ohio · 36815
Office
Unavailable
Facility
$121.97
No comparable office rate is available.
Oklahoma
Oklahoma · 36815
Office
Unavailable
Facility
$116.70
No comparable office rate is available.
Portland
Oregon · 36815
Office
Unavailable
Facility
$120.99
No comparable office rate is available.
Rest Of Oregon
Oregon · 36815
Office
Unavailable
Facility
$116.83
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 36815
Office
Unavailable
Facility
$129.59
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 36815
Office
Unavailable
Facility
$120.70
No comparable office rate is available.
Puerto Rico
Puerto Rico · 36815
Office
Unavailable
Facility
$123.11
No comparable office rate is available.
Rhode Island
Rhode Island · 36815
Office
Unavailable
Facility
$123.11
No comparable office rate is available.
South Carolina
South Carolina · 36815
Office
Unavailable
Facility
$118.77
No comparable office rate is available.
South Dakota**
South Dakota · 36815
Office
Unavailable
Facility
$109.06
No comparable office rate is available.
Tennessee
Tennessee · 36815
Office
Unavailable
Facility
$111.83
No comparable office rate is available.
Austin
Texas · 36815
Office
Unavailable
Facility
$121.95
No comparable office rate is available.
Beaumont
Texas · 36815
Office
Unavailable
Facility
$120.23
No comparable office rate is available.
Brazoria
Texas · 36815
Office
Unavailable
Facility
$119.08
No comparable office rate is available.
Dallas
Texas · 36815
Office
Unavailable
Facility
$120.91
No comparable office rate is available.
Fort Worth
Texas · 36815
Office
Unavailable
Facility
$121.02
No comparable office rate is available.
Galveston
Texas · 36815
Office
Unavailable
Facility
$120.14
No comparable office rate is available.
Houston
Texas · 36815
Office
Unavailable
Facility
$131.85
No comparable office rate is available.
Rest Of Texas
Texas · 36815
Office
Unavailable
Facility
$120.32
No comparable office rate is available.
Utah
Utah · 36815
Office
Unavailable
Facility
$120.07
No comparable office rate is available.
Virginia
Virginia · 36815
Office
Unavailable
Facility
$116.68
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 36815
Office
Unavailable
Facility
$123.11
No comparable office rate is available.
Vermont
Vermont · 36815
Office
Unavailable
Facility
$112.52
No comparable office rate is available.
Rest Of Washington
Washington · 36815
Office
Unavailable
Facility
$120.13
No comparable office rate is available.
Seattle (King Cnty)
Washington · 36815
Office
Unavailable
Facility
$127.39
No comparable office rate is available.
Wisconsin
Wisconsin · 36815
Office
Unavailable
Facility
$107.76
No comparable office rate is available.
West Virginia
West Virginia · 36815
Office
Unavailable
Facility
$130.27
No comparable office rate is available.
See how rates vary across the country
36815 · 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 / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, 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 36815 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$129.46
$117.69 × 110% = $129.46
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.
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 36815 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,545
- Code
- 36815
- Physician work
- 2.55
- Practice expense
- 0.50
- Malpractice
- 0.64
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.55 | × 1.000 | 2.5500 |
| Practice expense | 0.50 | × 1.000 | 0.5000 |
| Malpractice | 0.64 | × 0.740 | 0.4736 |
| Total RVUs | 3.5236 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$117.69
Open 36815 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.55 | 1 |
| Practice expense | 0.5 | 1 |
| Malpractice | 0.64 | 0.74 |
(2.55 × 1 + 0.5 × 1 + 0.64 × 0.74) × $33.4009 = $117.69
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
36815 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
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 from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $117.69 | RVU26D |
| 2026-07-01 | Not available in this setting | $117.69 | RVU26C |
| 2026-04-01 | Not available in this setting | $117.69 | RVU26B |
| 2026-01-01 | Not available in this setting | $117.69 | RVU26A |
| 2025-10-01 | Not available in this setting | $123.66 | RVU25D |
| 2025-07-01 | Not available in this setting | $123.66 | RVU25C |
| 2025-04-01 | Not available in this setting | $123.66 | RVU25B |
| 2025-01-01 | Not available in this setting | $123.66 | RVU25A |
36815 billing questions
How is this different from 36810?
This code is for cannula placement in an internal AV fistula. Code 36810 concerns an external arteriovenous shunt.
Does this code create the AV fistula?
No. It describes cannula insertion in an internal fistula; fistula creation is a different service, such as the procedure represented by 36821.
What documentation supports reporting this code?
Document the internal AV fistula as the access site and describe the operative cannula insertion. The note should distinguish the service from creation of the fistula.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's payment.
Can an assistant surgeon or co-surgeon be billed?
Assistant-at-surgery services are not paid. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
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.
4,54236680,,Insert needle bone cavity,A,,1.17,0.33,NA,0.33,,0.23,1.73,1.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54336800,,Insertion of cannula,A,,2.37,0.58,NA,0.58,,0.27,3.22,3.22,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54436810,,Insertion of cannula,A,,3.86,1.11,NA,1.11,,0.34,5.31,5.31,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54536815,,Insertion of cannula,A,,2.55,0.50,NA,0.50,,0.64,3.69,3.69,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54636818,,Av fuse uppr arm cephalic,A,,12.08,3.69,NA,3.69,,3.05,18.82,18.82,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54736819,,Av fuse uppr arm basilic,A,,12.96,3.60,NA,3.60,,3.31,19.87,19.87,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54836820,,Av fusion/forearm vein,A,,12.74,3.89,NA,3.89,,3.24,19.87,19.87,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,