No office rate
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.
On this page
CMS RVU26D · Effective 2026-10-01
36833 Fistula revision Medicare reimbursement rates in Wyoming
Open revision of a hemodialysis arteriovenous fistula with clot removal, reported when the surgeon corrects access anatomy and performs thrombectomy in one operation. Compare 36833 office and facility rates across CMS payment localities in Wyoming.
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 36833 in Wyoming?
Wyoming 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
No supported rate
Facility setting
$705.14
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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 surgery
About 36833: Open fistula revision with thrombectomy
Open revision of a hemodialysis arteriovenous fistula with clot removal, reported when the surgeon corrects access anatomy and performs thrombectomy in one operation.
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.
CMS billing rules for 36833
- 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 RVU14.14 · 64%
- Practice expense (office) RVU4.30 · 20%
- Malpractice RVU3.61 · 16%
3.1K
Medicare services in 2024 · #2148 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.
36833 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
36832 is open fistula revision without thrombectomy. Report 36833 when the operative service includes both revision and clot removal.
$1,184.49
36902 is an endovascular dialysis-circuit angioplasty service. It differs from the open fistula revision with thrombectomy described by 36833.
Compare 36833 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$705.14
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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 36833 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,555
- Code
- 36833
- Physician work
- 14.14
- Practice expense
- 4.30
- Malpractice
- 3.61
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.14 | × 1.000 | 14.1400 |
| Practice expense | 4.30 | × 1.000 | 4.3000 |
| Malpractice | 3.61 | × 0.740 | 2.6714 |
| Total RVUs | 21.1114 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$705.14
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.14 | 1 |
| Practice expense | 4.3 | 1 |
| Malpractice | 3.61 | 0.74 |
(14.14 × 1 + 4.3 × 1 + 3.61 × 0.74) × $33.4009 = $705.14
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.
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 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.
4,55236830,,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
4,55736836,,Prq av fstl crtj uxtr 1 acs,A,,7.02,232.45,,1.34,,1.03,240.50,9.39,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,55836837,,Prq av fstl crt uxtr sep acs,A,,9.07,261.75,,1.52,,1.41,272.23,12.00,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,