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 Dialysis cannula Medicare reimbursement rates in Hawaii
Reports surgical placement of a cannula in an internal arteriovenous fistula for hemodialysis or another intended purpose. Compare 36815 office and facility rates across CMS payment localities in Hawaii.
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 36815 in Hawaii?
Hawaii 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
$116.54
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 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 Hawaii, 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.
Compare 36815 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
Hawaii, Guam →
Office / nonfacility
Unavailable
Facility
$116.54
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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 36815 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
4,545
- Code
- 36815
- Physician work
- 2.55
- Practice expense
- 0.50
- Malpractice
- 0.64
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.55 | × 1.000 | 2.5500 |
| Practice expense | 0.50 | × 1.137 | 0.5685 |
| Malpractice | 0.64 | × 0.579 | 0.3706 |
| Total RVUs | 3.4891 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Hawaii, Guam$116.54
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.55 | 1 |
| Practice expense | 0.5 | 1.137 |
| Malpractice | 0.64 | 0.579 |
(2.55 × 1 + 0.5 × 1.137 + 0.64 × 0.579) × $33.4009 = $116.54
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.
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
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014