Billing code 36830: AV graft creationMedicare rate & RVUs in Alaska
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 doesn’t publish an office rate for 36830 in Alaska.
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 9 sections
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.
36830 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $765.62 |
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
Work11.73
11.73 RVUs× 1.000 GPCI
Practice expense3.45
3.45 RVUs× 1.000 GPCI
Malpractice3.00
3.00 RVUs× 1.000 GPCI
Adjusted RVUs
18.1800
Conversion factor
$33.4009
Medicare rate
$607.23
Every GPCI starts 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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share 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.
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%).
36830 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
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