CPT 36906: Dialysis access interventionMedicare rate & RVUs in Missouri
Reports catheter-based clot removal or thrombolysis in a dialysis access circuit together with balloon treatment of a central venous narrowing.
Medicare pays $5,151.14–$5,649.84 for 36906 in the office in Missouri, from Rest Of Missouri to Metropolitan St. Louis. 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 36906 covers
This service treats a clotted hemodialysis access circuit, such as an arteriovenous fistula or graft, by removing clot mechanically or using thrombolytic infusion and dilating a narrowing in the central venous outflow with a balloon. Interventional radiologists, vascular surgeons, and clinicians who perform dialysis-access interventions commonly provide it in an angiography suite or hospital procedure room. Imaging used to guide and assess the treatment is included in the service.
Select this code when the session includes clot treatment and balloon angioplasty of the central dialysis segment. The report should identify the access circuit, the clot treatment performed, the central narrowing treated, and the imaging findings supporting the intervention. Same-day preoperative and postoperative care is included in the 0-day global period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment is barred by statute; co-surgeons are paid only with 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 36906 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$5151.14 to $5649.84
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | $5,576.76 | $440.68 |
| Metropolitan St. Louis | $5,649.84 | $442.66 |
| Rest Of Missouri | $5,151.14 | $436.23 |
How the 36906 rate is calculated
Each of 36906’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 · 36906
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.16Practice expense 165.43Malpractice 1.50
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36906
The CMS indicators that decide how 36906 is paid alongside other services.
CMS payment indicators · 36906
Dialysis access intervention
| 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
36906 without 51 · national office
$5,914.97
Dialysis access intervention
36906-51 · Second procedure: 50%
$2,957.49
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%).
36906 compared with similar codes
Compare codes
36906 vs 36904 vs 36905 vs 36907 vs 36908: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 36904Dialysis thrombectomy
- Choose 36904 for dialysis-circuit clot treatment without the central balloon angioplasty included in 36906.
- 36905Dialysis thrombectomy
- Choose 36905 when clot treatment is paired with balloon angioplasty in the peripheral dialysis segment, rather than the central segment.
- 36907Dialysis angioplasty
- 36907 is an add-on for central-segment balloon angioplasty with an eligible primary service when that angioplasty is not already included in the primary code.
- 36908Stent placement
- 36908 covers central-segment stent placement as an add-on; 36906 represents clot treatment with central balloon angioplasty.
36906 billing questions
How does this differ from 36905?
Both include clot treatment in the dialysis circuit and balloon angioplasty. Use 36906 when the balloon treatment is in the central dialysis segment; 36905 identifies angioplasty in the peripheral segment.
Can 36906 be reported with 36907 for the same central angioplasty?
The central-segment balloon treatment is included in 36906. Do not separately report 36907 for that same angioplasty.
Is imaging separately reported with this service?
Imaging used for the dialysis-circuit intervention and its radiological supervision and interpretation are included in the service.
What should the procedure note support?
Document the dialysis access circuit, the mechanical clot removal or thrombolytic treatment performed, and the central-segment narrowing treated with a balloon.
How are other 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.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons are payable only when supporting documentation is provided.
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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