Billing code 36825: Dialysis accessMedicare rate & RVUs in Illinois
Reports surgical creation of hemodialysis access using the patient’s own vein as a graft rather than a direct artery-to-vein connection.
CMS doesn’t publish an office rate for 36825 in Illinois.
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 36825 covers
Code 36825 represents surgical creation of hemodialysis access using a vein from the same patient as a conduit, rather than joining a native artery and vein directly. A vascular surgeon typically uses this approach when an autogenous vein graft is selected to establish arteriovenous access. These procedures are generally performed in an operating room for patients needing long-term dialysis access.
Report the access-creation operation when the operative note identifies the patient’s vein as the conduit and distinguishes the construction from direct-anastomosis access or a prosthetic graft. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care through day 90. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures at 50%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted. Modifier 50 is inappropriate for this code.
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.
Where 36825 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $878.61 |
| East St. Louis | Unavailable | $830.08 |
| Rest Of Illinois | Unavailable | $775.62 |
| Suburban Chicago | Unavailable | $819.70 |
How the 36825 rate is calculated
Each of 36825’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 · 36825
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.82Practice expense 4.22Malpractice 3.55
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36825
36825 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 36825
Dialysis access
| 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 · 36825
Dialysis access
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
36825 without 51 · national facility
$721.13
Dialysis access
36825-51 · Second procedure: 50%
$360.57
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%).
36825 compared with similar codes
Compare codes
36825 vs 36830 vs 36821 vs 36818 vs 36819: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 36830AV graft creation
- Choose 36825 when the conduit is the patient’s own vein; choose 36830 when access is created with a nonautologous graft.
- 36821Dialysis access
- Code 36821 describes direct artery-to-vein access creation. Code 36825 uses an autologous vein graft rather than a direct anastomosis.
- 36818AV fistula creation
- Code 36818 describes direct access creation using the upper-arm cephalic vein. Code 36825 is for access constructed with an autologous graft.
- 36819Dialysis access
- Code 36819 describes direct access creation using the upper-arm basilic vein. Code 36825 uses an autologous vein graft conduit.
36825 billing questions
How is 36825 different from 36830?
Code 36825 uses the patient’s own vein as the graft conduit. Code 36830 describes access creation using a nonautologous graft.
When should a direct-anastomosis code be used instead?
Use a direct-anastomosis code when the surgeon connects the artery and vein directly without an interposed autologous graft. Codes 36818, 36819, 36820, and 36821 describe direct access creation in specified settings.
Does the 90-day global period include postoperative care?
Yes. The CMS global period includes the day-before preoperative visit and related postoperative care through day 90.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this code.
What documentation supports reporting 36825?
The operative note should identify the autologous vein conduit and describe creation of the access using a graft rather than a direct artery-to-vein connection.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.
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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