$1,756.34
36904 covers dialysis-circuit thrombectomy or thrombolytic treatment without peripheral balloon angioplasty. Choose 36905 when that angioplasty is also performed.
On this page
CMS RVU26D · Effective 2026-10-01
36905 Dialysis thrombectomy Medicare reimbursement rates in Puerto Rico
Reports percutaneous removal or dissolution of thrombus in a dialysis access circuit together with balloon angioplasty of a stenosis in its peripheral segment. Compare 36905 office and facility rates across CMS payment localities in Puerto Rico.
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 36905 in Puerto Rico?
Puerto Rico 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
$2225.04
1 of 1 localities have a supported rate.
Payment area: Puerto Rico
One mapped payment locality.
Facility setting
$385.68
1 of 1 localities have a supported rate.
Payment area: Puerto Rico
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.
Vascular intervention
About 36905: Dialysis circuit thrombectomy with angioplasty
Reports percutaneous removal or dissolution of thrombus in a dialysis access circuit together with balloon angioplasty of a stenosis in its peripheral segment.
This service treats a thrombosed or occluded hemodialysis access, such as an arteriovenous fistula or graft. A vascular surgeon or interventional radiologist accesses the circuit percutaneously, removes or dissolves thrombus, and uses a balloon to treat a stenosis in the peripheral portion of the circuit. Imaging and radiological supervision associated with the intervention are included. The service is commonly performed in a hospital or an outpatient vascular access setting when restoring access flow requires both clot treatment and angioplasty.
Select this code when thrombectomy or thrombolytic treatment and peripheral-segment balloon angioplasty are performed in the same dialysis circuit. Use a different code when the procedure lacks one of those elements or uses stenting instead of balloon angioplasty. The report should identify the treated access, thrombus treatment, angioplasty site, and relevant findings. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. In a session with multiple procedures, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment is statutorily restricted; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 36905
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.78 · 13%
- Practice expense (office) RVU55.95 · 85%
- Malpractice RVU1.29 · 2%
22.2K
Medicare services in 2024 · #1107 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.
36905 compared with similar codes
Office rates for Puerto Rico, from the same CMS release.
$1,201.48
36902 covers peripheral balloon angioplasty without thrombectomy or thrombolytic treatment. When both clot treatment and peripheral angioplasty are performed, use 36905 rather than reporting both codes.
$5,974.99
Both codes include thrombectomy or thrombolytic treatment, but 36906 is for peripheral-segment stent placement; 36905 is for balloon angioplasty there.
$583.40
36907 is an add-on for central-segment balloon angioplasty, not the primary thrombectomy service. It may accompany 36905 when that separate central treatment is performed.
Compare 36905 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
Puerto Rico →
Office / nonfacility
$2225.04
Facility
$385.68
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 36905 in Puerto Rico.
PPRRVU2026_Oct_nonQPP.csv
4,566
- Code
- 36905
- Physician work
- 8.78
- Practice expense
- 55.95
- Malpractice
- 1.29
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.78 | × 1.000 | 8.7800 |
| Practice expense | 55.95 | × 1.011 | 56.5654 |
| Malpractice | 1.29 | × 0.985 | 1.2707 |
| Total RVUs | 66.6161 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Puerto Rico$2225.04
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.78 | 1 |
| Practice expense | 55.95 | 1.011 |
| Malpractice | 1.29 | 0.985 |
(8.78 × 1 + 55.95 × 1.011 + 1.29 × 0.985) × $33.4009 = $2225.04
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.78 | 1 |
| Practice expense | 1.48 | 1.011 |
| Malpractice | 1.29 | 0.985 |
(8.78 × 1 + 1.48 × 1.011 + 1.29 × 0.985) × $33.4009 = $385.68
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.
36905 billing questions
When is this code selected instead of 36904?
Use 36905 when thrombectomy or thrombolytic treatment is accompanied by balloon angioplasty in the peripheral dialysis-circuit segment. Code 36904 describes circuit thrombectomy without that peripheral angioplasty.
Can 36902 also be reported for the peripheral angioplasty?
No. The peripheral balloon angioplasty is included in 36905 when performed with the circuit thrombectomy or thrombolytic treatment.
How does 36905 differ from 36906?
Both include dialysis-circuit thrombectomy or thrombolytic treatment. Use 36905 when the peripheral lesion is treated with balloon angioplasty; 36906 represents peripheral-segment stent placement.
Can central-segment treatment be reported separately?
A separately performed central-segment balloon angioplasty may be reported with add-on code 36907. Central-segment stent placement is represented by add-on code 36908.
Should modifier 50 be appended for bilateral access treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code; modifier 50 should not be used.
What documentation supports reporting 36905?
Document the dialysis access treated, the thrombectomy or thrombolytic work, and the peripheral-segment stenosis treated with balloon angioplasty. Include the procedural findings and imaging that support those services.
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.
4,56336902,,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
4,56536904,,Thrmbc/nfs dialysis circuit,A,,7.31,43.68,,1.16,,1.13,52.12,9.60,0,000,0.00,0.00,0.00,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,56636905,,Thrmbc/nfs dialysis circuit,A,,8.78,55.95,,1.48,,1.29,66.02,11.55,0,000,0.00,0.00,0.00,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,56736906,,Thrmbc/nfs dialysis circuit,A,,10.16,165.43,,1.67,,1.50,177.09,13.33,0,000,0.00,0.00,0.00,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,56836907,,Balo angiop ctr dialysis seg,A,,2.93,13.94,,0.44,,0.45,17.32,3.82,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,56936908,,Stent plmt ctr dialysis seg,A,,4.14,36.82,,0.61,,0.69,41.65,5.44,0,ZZZ,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336