CPT code 36837: AV fistula creation2026 Medicare rate & RVUs in Illinois
Reports endovascular creation of an upper-extremity dialysis fistula using separate access sites, rather than the single-access approach described by its sibling code.
Medicare pays $8,358.63–$9,367.26 for 36837 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. 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 36837 covers
This service creates an arteriovenous connection in an upper extremity through a catheter-based approach, using separate access sites to bring the target artery and vein together. It is performed by a vascular surgeon or other qualified procedural physician, typically in a hospital or ambulatory setting, to establish hemodialysis access. Imaging guidance, monitoring, and associated access and catheter work are part of the service when performed; they are not separate creation procedures.
Select this code when the documented percutaneous creation uses separate access sites; use the single-access sibling when that approach is documented. The operative report should identify the access sites and describe the artery-vein connection created. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be allowed; co-surgeon payment requires 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.
Where 36837 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.
4 payment localities
$8358.63 to $9367.26
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $9,199.55 | $464.17 |
| East St. Louis | $8,441.07 | $444.50 |
| Rest Of Illinois | $8,358.63 | $422.91 |
| Suburban Chicago | $9,367.26 | $440.66 |
How the 36837 rate is calculated
Each of 36837’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 · 36837
RVUs × geographic indexes × conversion factor
Work9.07
9.07 RVUs× 1.000 GPCI
Practice expense261.75
261.75 RVUs× 1.000 GPCI
Malpractice1.41
1.41 RVUs× 1.000 GPCI
Adjusted RVUs
272.2300
Conversion factor
$33.4009
Medicare rate
$9,092.73
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36837
The CMS indicators that decide how 36837 is paid alongside other services.
CMS payment indicators · 36837
AV fistula creation
| 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) | 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
36837 without 51 · national office
$9,092.73
AV fistula creation
36837-51 · Second procedure: 50%
$4,546.37
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%).
36837 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 36836AV fistula creation
- Both describe percutaneous upper-extremity fistula creation. Choose 36837 for separate access sites and 36836 for the single-access approach.
- 36821Dialysis access
- 36821 describes open direct fistula creation. 36837 is for a percutaneous approach using separate access sites.
- 36825Dialysis access
- 36825 creates dialysis access with an autogenous graft; 36837 creates a fistula percutaneously without that graft approach.
- 36830AV graft creation
- 36830 uses a nonautogenous graft to create dialysis access. 36837 describes percutaneous fistula creation through separate access sites.
36837 billing questions
How does 36837 differ from 36836?
36837 describes percutaneous fistula creation using separate access sites. 36836 is the related code for the single-access approach; follow the documented technique.
Can imaging guidance or catheter access be billed separately?
Imaging guidance, monitoring, and associated access and catheter work are included in the creation service when performed. Do not report them as separate parts of this same creation.
Should modifier 50 be appended for bilateral work?
No. CMS identifies bilateral adjustment as inapplicable to this code, and modifier 50 is inappropriate.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure. CMS applies the standard multiple-procedure reduction when other procedures are performed in the same session.
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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