Billing code 36903: Dialysis access stentingMedicare rate & RVUs in Oregon
Reports angiography of a hemodialysis access circuit with stent placement in its peripheral segment, including angioplasty performed in that segment.
Medicare pays $4,773.92–$5,303.05 for 36903 in the office in Oregon, from Rest Of Oregon to Portland. 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 36903 covers
An interventional radiologist, vascular surgeon, or other qualified physician accesses a hemodialysis fistula or graft with needles or catheters, performs diagnostic angiography, and places a stent to treat a lesion in the peripheral dialysis segment. Typical cases involve a stenosis compromising access flow or dialysis function. The service may take place in an outpatient angiography suite or hospital procedure room. Angioplasty performed in the same peripheral segment is included in this code.
Report 36903 when the documented intervention includes peripheral-segment stent placement; angiography and the stent location should be clear in the procedure report. The code includes the imaging and its interpretation for the circuit evaluation and intervention, so those elements are not separately reported for the same service. It has a 0-day global period, with same-day preoperative and postoperative care included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeon and team-surgery billing are 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 36903 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $5,303.05 | $275.98 |
| Rest Of Oregon | $4,773.92 | $267.20 |
How the 36903 rate is calculated
Each of 36903’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 · 36903
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 6.23Practice expense 136.52Malpractice 1.03
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36903
The CMS indicators that decide how 36903 is paid alongside other services.
CMS payment indicators · 36903
Dialysis access stenting
| 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) | 0 | Not permitted. |
| 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
36903 without 51 · national office
$4,802.38
Dialysis access stenting
36903-51 · Second procedure: 50%
$2,401.19
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%).
36903 compared with similar codes
Compare codes
36903 vs 36902 vs 36906 vs 36908: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 36902Dialysis access angioplasty
- Use 36902 for peripheral-segment angioplasty without a stent. Use 36903 when a peripheral-segment stent is placed; angioplasty in that same segment is included.
- 36906Dialysis access intervention
- Both involve peripheral-segment stenting, but 36906 includes dialysis-circuit thrombectomy with thrombolysis. Use 36903 when the service does not include that thrombectomy treatment.
- 36908Stent placement
- 36908 is for stent placement in the central dialysis segment and is an add-on code. 36903 describes the primary intervention with stenting in the peripheral segment.
36903 billing questions
When should 36903 be chosen instead of 36902?
Choose 36903 when a stent is placed in the peripheral dialysis segment. Code 36902 describes peripheral-segment angioplasty without stent placement.
Can angioplasty in the stented peripheral segment be reported separately?
No. Angioplasty performed in the same peripheral segment as the stent is included in 36903.
Is the diagnostic angiography separately billable with 36903?
The circuit angiography and its imaging and interpretation are included in 36903 for the service being reported.
Can 36907 or 36908 be reported with 36903?
They may be reported as add-on codes when a separate intervention is performed in the central dialysis segment: angioplasty for 36907 or stent placement for 36908.
Should modifier 50 be appended for treatment of both sides?
No. The descriptor or anatomy makes modifier 50 inappropriate for 36903.
What documentation supports 36903?
Document the access circuit evaluated, angiographic findings, the peripheral-segment site treated, and the stent placement. Record any angioplasty performed in that same segment as part of the service.
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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