$234.07
Choose 36860 for declotting an external arteriovenous cannula; 36861 describes an internal cannula.
On this page
CMS RVU26D · Effective 2026-10-01
36861 Cannula declotting Medicare reimbursement rates in Nebraska
Declotting an internal arteriovenous dialysis cannula to restore access flow when treatment is directed at the cannula rather than open fistula thrombectomy. Compare 36861 office and facility rates across CMS payment localities in Nebraska.
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 36861 in Nebraska?
Nebraska 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
$108.56
1 of 1 localities have a supported rate.
Payment area: Nebraska
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.
Dialysis access
About 36861: Internal dialysis cannula declotting
Declotting an internal arteriovenous dialysis cannula to restore access flow when treatment is directed at the cannula rather than open fistula thrombectomy.
This service removes obstructing clot from an internal arteriovenous cannula used for hemodialysis, with the goal of restoring flow through the access. A vascular surgeon or another physician who manages dialysis access may perform it when the problem is the cannula itself. It is distinct from open thrombectomy of the arteriovenous fistula and from declotting an external cannula.
Report the code when the documentation identifies an internal dialysis cannula and describes the clot removal performed. A 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed 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. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
CMS billing rules for 36861
- 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 RVU2.46 · 66%
- Practice expense (office) RVU0.59 · 16%
- Malpractice RVU0.65 · 18%
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.
36861 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
36831 describes open thrombectomy of an arteriovenous fistula. Use 36861 when the documented treatment is directed at the internal cannula.
$1,605.04
36904 describes percutaneous transluminal thrombectomy of a dialysis circuit. This code describes declotting an internal cannula, not an endovascular circuit thrombectomy.
Compare 36861 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$108.56
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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 36861 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
4,561
- Code
- 36861
- Physician work
- 2.46
- Practice expense
- 0.59
- Malpractice
- 0.65
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.46 | × 1.000 | 2.4600 |
| Practice expense | 0.59 | × 0.923 | 0.5446 |
| Malpractice | 0.65 | × 0.378 | 0.2457 |
| Total RVUs | 3.2503 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$108.56
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.46 | 1 |
| Practice expense | 0.59 | 0.923 |
| Malpractice | 0.65 | 0.378 |
(2.46 × 1 + 0.59 × 0.923 + 0.65 × 0.378) × $33.4009 = $108.56
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.
36861 billing questions
How is this different from 36860?
This code describes declotting an internal arteriovenous cannula. Code 36860 is for an external cannula.
When would 36831 be more appropriate?
Use 36831 for open thrombectomy of an arteriovenous fistula. This code is for clot removal directed at the internal cannula.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
What documentation supports reporting this code?
Document that the cannula is internal, that clot obstructed it, and that the service involved removal of that clot. Distinguish cannula declotting from open fistula thrombectomy.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Same-day preoperative and postoperative care is included in this code's 0-day global period.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
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.
4,55836837,,Prq av fstl crt uxtr sep acs,A,,9.07,261.75,,1.52,,1.41,272.23,12.00,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55936838,,Dist revas ligation hemo,A,,21.15,4.31,NA,4.31,,5.39,30.85,30.85,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,56036860,,External cannula declotting,A,,1.96,5.26,,0.47,,0.51,7.73,2.94,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,56136861,,Cannula declotting,A,,2.46,0.59,NA,0.59,,0.65,3.70,3.70,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,56236901,,Intro cath dialysis circuit,A,,3.28,16.76,,0.62,,0.51,20.55,4.41,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,56336902,,Intro cath dialysis circuit,A,,4.71,30.22,,0.86,,0.72,35.65,6.29,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,56436903,,Intro cath dialysis circuit,A,,6.23,136.52,,1.05,,1.03,143.78,8.31,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068