No office rate
36823 reports cannula insertion. Use 36821 when the surgeon creates a direct arteriovenous fistula.
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CMS RVU26D · Effective 2026-10-01
36823 Cannula insertion Medicare reimbursement rates in Pennsylvania
Reports surgical insertion of cannulae for hemodialysis when the documented service matches this cannula-insertion code rather than access creation. Compare 36823 office and facility rates across CMS payment localities in Pennsylvania.
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 36823 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1275.79–$1384.24
2 of 2 localities have a supported rate.
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.
Vascular access
About 36823: Hemodialysis cannula insertion
Reports surgical insertion of cannulae for hemodialysis when the documented service matches this cannula-insertion code rather than access creation.
This service covers operative insertion of cannulae for hemodialysis. It is generally performed by a vascular or other access surgeon in a hospital or similar surgical setting. The operative report should identify the cannulae inserted and describe the procedure and vascular access involved; do not infer a particular access configuration from the abbreviated CMS descriptor alone.
Select 36823 only when the full code descriptor and operative details support it, rather than a neighboring cannula-insertion code or a code for creating an arteriovenous fistula or graft. Documentation should make the procedure performed clear enough to distinguish insertion from access construction. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeon and team-surgery billing are not permitted.
CMS billing rules for 36823
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 RVU22.41 · 57%
- Practice expense (office) RVU11.02 · 28%
- Malpractice RVU6.00 · 15%
14
Medicare services in 2024 · #6099 by national volume
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.
36823 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
36825 describes creation of an arteriovenous access using an autograft; 36823 is for cannula insertion.
No office rate
36835 describes insertion of a Thomas shunt. Do not substitute it for 36823 unless the operative service matches the shunt procedure.
Compare 36823 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$1384.24
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$1275.79
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36823 billing questions
How do I distinguish 36823 from the neighboring cannula-insertion codes?
Use the full code descriptors and the operative report to match the specific cannula-insertion service performed. The abbreviated CMS descriptor alone does not establish the configuration.
Is 36823 an access-creation code?
No. It describes cannula insertion; codes such as 36821 and 36825 describe creation of an arteriovenous access.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply to 36823, and modifier 50 is inappropriate.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant or co-surgeon be billed?
Assistant-at-surgery payment is restricted. Co-surgeon and team-surgery billing are not permitted for this code.
How are other procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% 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 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.
4,54736819,,Av fuse uppr arm basilic,A,,12.96,3.60,NA,3.60,,3.31,19.87,19.87,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54836820,,Av fusion/forearm vein,A,,12.74,3.89,NA,3.89,,3.24,19.87,19.87,0,090,0.09,0.84,0.07,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,54936821,,Av fusion direct any site,A,,11.60,3.44,NA,3.44,,2.95,17.99,17.99,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55036823,,Insertion of cannula(s),A,,22.41,11.02,NA,11.02,,6.00,39.43,39.43,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55136825,,Artery-vein autograft,A,,13.82,4.22,NA,4.22,,3.55,21.59,21.59,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55236830,,Artery-vein nonautograft,A,,11.73,3.45,NA,3.45,,3.00,18.18,18.18,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55336831,,Open thrombect av fistula,A,,10.73,3.46,NA,3.46,,2.75,16.94,16.94,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00