Billing code 36905: Dialysis thrombectomyMedicare rate & RVUs in Delaware
Reports percutaneous removal or dissolution of thrombus in a dialysis access circuit together with balloon angioplasty of a stenosis in its peripheral segment.
Medicare pays $2,179.82 for 36905 in the office in Delaware (Delaware). Which amount applies depends on the service address.
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 36905 covers
This service treats a thrombosed or occluded hemodialysis access, such as an arteriovenous fistula or graft. A vascular surgeon or interventional radiologist accesses the circuit percutaneously, removes or dissolves thrombus, and uses a balloon to treat a stenosis in the peripheral portion of the circuit. Imaging and radiological supervision associated with the intervention are included. The service is commonly performed in a hospital or an outpatient vascular access setting when restoring access flow requires both clot treatment and angioplasty.
Select this code when thrombectomy or thrombolytic treatment and peripheral-segment balloon angioplasty are performed in the same dialysis circuit. Use a different code when the procedure lacks one of those elements or uses stenting instead of balloon angioplasty. The report should identify the treated access, thrombus treatment, angioplasty site, and relevant findings. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. In a session with multiple procedures, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; co-surgeons require 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.
36905 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $2,179.82 | $382.30 |
How the 36905 rate is calculated
Each of 36905’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 · 36905
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.78Practice expense 55.95Malpractice 1.29
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36905
The CMS indicators that decide how 36905 is paid alongside other services.
CMS payment indicators · 36905
Dialysis thrombectomy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
36905 without 51 · national office
$2,205.13
Dialysis thrombectomy
36905-51 · Second procedure: 50%
$1,102.57
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%).
36905 compared with similar codes
Compare codes
36905 vs 36904 vs 36902 vs 36906 vs 36907: national Medicare rates
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How to choose
- 36904Dialysis thrombectomy
- 36904 covers dialysis-circuit thrombectomy or thrombolytic treatment without peripheral balloon angioplasty. Choose 36905 when that angioplasty is also performed.
- 36902Dialysis access angioplasty
- 36902 covers peripheral balloon angioplasty without thrombectomy or thrombolytic treatment. When both clot treatment and peripheral angioplasty are performed, use 36905 rather than reporting both codes.
- 36906Dialysis access intervention
- Both codes include thrombectomy or thrombolytic treatment, but 36906 is for peripheral-segment stent placement; 36905 is for balloon angioplasty there.
- 36907Dialysis angioplasty
- 36907 is an add-on for central-segment balloon angioplasty, not the primary thrombectomy service. It may accompany 36905 when that separate central treatment is performed.
36905 billing questions
When is this code selected instead of 36904?
Use 36905 when thrombectomy or thrombolytic treatment is accompanied by balloon angioplasty in the peripheral dialysis-circuit segment. Code 36904 describes circuit thrombectomy without that peripheral angioplasty.
Can 36902 also be reported for the peripheral angioplasty?
No. The peripheral balloon angioplasty is included in 36905 when performed with the circuit thrombectomy or thrombolytic treatment.
How does 36905 differ from 36906?
Both include dialysis-circuit thrombectomy or thrombolytic treatment. Use 36905 when the peripheral lesion is treated with balloon angioplasty; 36906 represents peripheral-segment stent placement.
Can central-segment treatment be reported separately?
A separately performed central-segment balloon angioplasty may be reported with add-on code 36907. Central-segment stent placement is represented by add-on code 36908.
Should modifier 50 be appended for bilateral access treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What documentation supports reporting 36905?
Document the dialysis access treated, the thrombectomy or thrombolytic work, and the peripheral-segment stenosis treated with balloon angioplasty. Include the procedural findings and imaging that support those services.
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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