No office rate
36832 describes open fistula revision without thrombectomy. Choose 36831 when open clot removal is performed without revising the access.
On this page
CMS RVU26D · Effective 2026-10-01
36831 Fistula thrombectomy Medicare reimbursement rates in Pennsylvania
Open removal of thrombus from a hemodialysis arteriovenous fistula without revising the access when clot obstructs fistula flow. Compare 36831 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 36831 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
$551.28–$594.73
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 surgery
About 36831: Open arteriovenous fistula thrombectomy
Open removal of thrombus from a hemodialysis arteriovenous fistula without revising the access when clot obstructs fistula flow.
This service removes obstructing clot from a surgically created arteriovenous fistula through open surgical exposure, with the goal of restoring access flow. Vascular surgeons and other surgeons who manage dialysis access typically perform it in an operating room when a fistula has thrombosed. The code describes thrombectomy without revision of the fistula; it is not for declotting a cannula or treating a graft as though it were a fistula.
Report the code when the operative record supports open clot removal from the fistula and no access revision is performed. Document the access site, open approach, thrombus removal, and whether the fistula was revised; when thrombectomy accompanies revision, consider 36833 instead. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 36831
- 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
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU10.73 · 63%
- Practice expense (office) RVU3.46 · 20%
- Malpractice RVU2.75 · 16%
2K
Medicare services in 2024 · #2447 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.
36831 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
36833 applies when open fistula revision and thrombectomy are both performed. 36831 is for thrombectomy without revision.
$242.85–$269.86
36860 concerns declotting an external dialysis cannula. 36831 is for open removal of thrombus from the fistula itself.
No office rate
36861 is a cannula-declotting service, while 36831 addresses open thrombectomy of the arteriovenous fistula.
Compare 36831 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
$594.73
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$551.28
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36831 billing questions
When should 36831 be chosen over 36833?
Use 36831 for open fistula thrombectomy without revision. When the surgeon revises the fistula and removes thrombus during the procedure, 36833 describes that combination.
Can 36831 be reported for declotting a dialysis cannula?
No. This code concerns open thrombectomy of the arteriovenous fistula itself; codes 36860 and 36861 concern cannula declotting.
What documentation supports reporting 36831?
The operative report should identify the fistula, describe open exposure and removal of thrombus, and clarify whether revision was performed.
Does modifier 50 apply when fistulas are treated on both sides?
CMS identifies bilateral adjustment as inappropriate for this code. Do not use modifier 50.
How does the 90-day global period affect postoperative reporting?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
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.
4,55036823,,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
4,55436832,,Av fistula revision open,A,,13.16,4.13,NA,4.13,,3.32,20.61,20.61,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55536833,,Av fistula revision,A,,14.14,4.30,NA,4.30,,3.61,22.05,22.05,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55636835,,Insertion thomas shunt,A,,7.32,5.11,NA,5.11,,1.84,14.27,14.27,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00