No office rate
Choose 36830 for access made with nonautologous graft material. Choose 36825 when the graft is harvested from the patient.
On this page
CMS RVU26D · Effective 2026-10-01
36830 AV graft creation Medicare reimbursement rates in California
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. Compare 36830 office and facility rates across CMS payment localities in California.
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 36830 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$578.46–$654.76
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $76.30 per service.
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.
Where 36830 pays more and less in California
Vascular surgery
About 36830: Arteriovenous access with nonautologous graft
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.
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.
CMS billing rules for 36830
- 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 RVU11.73 · 65%
- Practice expense (office) RVU3.45 · 19%
- Malpractice RVU3.00 · 17%
12.4K
Medicare services in 2024 · #1364 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.
36830 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
Code 36821 describes a direct artery-to-vein connection. Code 36830 involves an interposed nonautologous graft.
No office rate
Code 36818 is a direct upper-arm connection involving the cephalic vein. Code 36830 is selected when nonautologous graft material bridges the vessels.
No office rate
Code 36831 is for open thrombectomy of an existing arteriovenous fistula. Code 36830 creates access with a nonautologous graft.
Compare 36830 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $586.56 |
| Chico | Office Unavailable | Facility $578.46 |
| El Centro | Office Unavailable | Facility $578.96 |
| Fresno | Office Unavailable | Facility $578.46 |
| Hanford-Corcoran | Office Unavailable | Facility $578.46 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $610.71 |
| Madera | Office Unavailable | Facility $578.46 |
| Merced | Office Unavailable | Facility $578.46 |
| Modesto | Office Unavailable | Facility $578.46 |
| Napa | Office Unavailable | Facility $619.26 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $601.39 |
| Redding | Office Unavailable | Facility $578.46 |
| Rest Of California | Office Unavailable | Facility $578.46 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $610.61 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $593.62 |
| Salinas | Office Unavailable | Facility $591.20 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $595.67 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $637.48 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $634.08 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $654.76 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $640.84 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $583.41 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $593.74 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $590.83 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $598.76 |
| Stockton | Office Unavailable | Facility $578.46 |
| Vallejo | Office Unavailable | Facility $614.35 |
| Visalia | Office Unavailable | Facility $578.46 |
| Yuba City | Office Unavailable | Facility $578.46 |
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 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.
4,54936821,,Av fusion direct any site,A,,11.60,3.44,NA,3.44,,2.95,17.99,17.99,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55036823,,Insertion of cannula(s),A,,22.41,11.02,NA,11.02,,6.00,39.43,39.43,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55136825,,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