No office rate
Choose 36833 when open fistula revision includes thrombectomy. Code 36832 is for revision without thrombectomy.
On this page
CMS RVU26D · Effective 2026-10-01
36832 Fistula revision Medicare reimbursement rates in Arkansas
Reports open surgical revision of a hemodialysis arteriovenous fistula when the access needs repair or reconstruction and thrombectomy is not performed. Compare 36832 office and facility rates across CMS payment localities in Arkansas.
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.
What does Medicare pay for 36832 in Arkansas?
Arkansas has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$615.16
1 of 1 localities have a supported rate.
Payment area: Arkansas
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Vascular surgery
About 36832: Open arteriovenous fistula revision
Reports open surgical revision of a hemodialysis arteriovenous fistula when the access needs repair or reconstruction and thrombectomy is not performed.
This service covers open repair or reconfiguration of an existing arteriovenous fistula used for hemodialysis. A vascular surgeon or another surgeon experienced in dialysis access may revise a fistula to address a structural or functional problem, such as a narrowed segment or an aneurysmal area. The operation is performed in a surgical setting and is distinct from creating a new access or removing clot from the fistula as part of the revision.
Report 36832 when the operative work revises the existing fistula without thrombectomy; when revision includes thrombectomy, the related code is 36833. The operative report should identify the access, the problem treated, the open revision performed, and whether clot removal was part of the operation. 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 other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 36832
- 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 RVU13.16 · 64%
- Practice expense (office) RVU4.13 · 20%
- Malpractice RVU3.32 · 16%
14.5K
Medicare services in 2024 · #1276 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.
36832 compared with similar codes
Office rates for Arkansas, from the same CMS release.
No office rate
36831 is open clot removal without revision. If the surgeon revises the fistula without thrombectomy, use 36832.
No office rate
36821 describes creation of a new direct arteriovenous connection. Code 36832 revises an existing fistula.
No office rate
36830 describes creation of an arteriovenous access using a nonautologous graft; it is not revision of an existing fistula.
Compare 36832 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Arkansas →
Office / nonfacility
Unavailable
Facility
$615.16
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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 36832 in Arkansas.
PPRRVU2026_Oct_nonQPP.csv
4,554
- Code
- 36832
- Physician work
- 13.16
- Practice expense
- 4.13
- Malpractice
- 3.32
GPCI2026.csv
7
- Locality
- Arkansas
- Physician work
- 1.000
- Practice expense
- 0.859
- Malpractice
- 0.515
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 13.16 | × 1.000 | 13.1600 |
| Practice expense | 4.13 | × 0.859 | 3.5477 |
| Malpractice | 3.32 | × 0.515 | 1.7098 |
| Total RVUs | 18.4175 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arkansas$615.16
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 13.16 | 1 |
| Practice expense | 4.13 | 0.859 |
| Malpractice | 3.32 | 0.515 |
(13.16 × 1 + 4.13 × 0.859 + 3.32 × 0.515) × $33.4009 = $615.16
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.
36832 billing questions
How is 36832 different from 36833?
Use 36832 for open fistula revision without thrombectomy. When thrombectomy is performed as part of the revision, use 36833.
Can 36831 be reported with 36832 for clot removal?
36831 describes open thrombectomy without revision. When thrombectomy accompanies the open revision, 36833 is the corresponding code rather than separately reporting 36831 for that work.
What should the operative note document?
Document the existing dialysis fistula, the structural or functional problem, the open revision performed, and whether thrombectomy was included.
Can modifier 50 be used for a bilateral fistula revision?
CMS identifies bilateral adjustment as inappropriate for this code. The descriptor or anatomy makes modifier 50 unsuitable.
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.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
4,55136825,,Artery-vein autograft,A,,13.82,4.22,NA,4.22,,3.55,21.59,21.59,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55236830,,Artery-vein nonautograft,A,,11.73,3.45,NA,3.45,,3.00,18.18,18.18,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55336831,,Open thrombect av fistula,A,,10.73,3.46,NA,3.46,,2.75,16.94,16.94,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55436832,,Av fistula revision open,A,,13.16,4.13,NA,4.13,,3.32,20.61,20.61,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55536833,,Av fistula revision,A,,14.14,4.30,NA,4.30,,3.61,22.05,22.05,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55636835,,Insertion thomas shunt,A,,7.32,5.11,NA,5.11,,1.84,14.27,14.27,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55736836,,Prq av fstl crtj uxtr 1 acs,A,,7.02,232.45,,1.34,,1.03,240.50,9.39,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536
1001182,CA,71,EL CENTRO,1.017,1.096,0.541