Billing code 36833: Fistula revisionMedicare rate & RVUs in Virginia
Open revision of a hemodialysis arteriovenous fistula with clot removal, reported when the surgeon corrects access anatomy and performs thrombectomy in one operation.
CMS doesn’t publish an office rate for 36833 in Virginia.
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 36833 covers
A vascular surgeon uses this service to revise a hemodialysis arteriovenous fistula through open surgery while removing thrombus from the access. It fits an operation in which both clot removal and correction of the fistula are performed, such as addressing a thrombosed, dysfunctional dialysis access. The service is commonly performed in a hospital operating room or another surgical facility. It is distinct from an isolated open declot or a revision performed without thrombectomy.
The operative report should support both the open revision and thrombectomy; do not separately report the standalone thrombectomy or revision for the same work. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 36833 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | Unavailable | $801.18 |
| Virginia | Unavailable | $698.60 |
How the 36833 rate is calculated
Each of 36833’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 · 36833
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 14.14Practice expense 4.30Malpractice 3.61
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 36833
36833 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 36833
Fistula revision
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 36833
Fistula revision
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
36833 without 51 · national facility
$736.49
Fistula revision
36833-51 · Second procedure: 50%
$368.25
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%).
36833 compared with similar codes
Compare codes
36833 vs 36831 vs 36832 vs 36902: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 36831Fistula thrombectomy
- 36831 describes open thrombectomy of an AV fistula without the revision captured by 36833. Choose 36833 when the surgeon revises the fistula and removes thrombus in the same operation.
- 36832Fistula revision
- 36832 is open fistula revision without thrombectomy. Report 36833 when the operative service includes both revision and clot removal.
- 36902Dialysis access angioplasty
- 36902 is an endovascular dialysis-circuit angioplasty service. It differs from the open fistula revision with thrombectomy described by 36833.
36833 billing questions
How does this differ from 36832?
Use 36833 when the open fistula revision includes thrombectomy. Code 36832 describes open revision without thrombectomy.
Can 36831 also be reported for the clot removal?
Do not separately report 36831 for thrombectomy that is part of the same fistula revision operation. This code covers the combined revision and thrombectomy service.
What documentation supports reporting 36833?
The operative report should establish that the surgeon performed an open revision of the arteriovenous fistula and removed thrombus during that operation.
Can modifier 50 be used for bilateral fistulas?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
How is this code affected by the global period?
It has a 90-day global period, which includes the day-before preoperative visit and 90 days of related postoperative care.
May an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is 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 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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