CPT code 36861: Cannula declotting2026 Medicare rate & RVUs in Wyoming
Declotting an internal arteriovenous dialysis cannula to restore access flow when treatment is directed at the cannula rather than open fistula thrombectomy.
CMS doesn’t publish an office rate for 36861 in Wyoming.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 36861 covers
This service removes obstructing clot from an internal arteriovenous cannula used for hemodialysis, with the goal of restoring flow through the access. A vascular surgeon or another physician who manages dialysis access may perform it when the problem is the cannula itself. It is distinct from open thrombectomy of the arteriovenous fistula and from declotting an external cannula.
Report the code when the documentation identifies an internal dialysis cannula and describes the clot removal performed. A 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are 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.
36861 in Wyoming
| Payment locality | Office | Facility |
|---|---|---|
| Wyoming | Unavailable | $117.94 |
How the 36861 rate is calculated
Each of 36861’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 · 36861
RVUs × geographic indexes × conversion factor
Work2.46
2.46 RVUs× 1.000 GPCI
Practice expense0.59
0.59 RVUs× 1.000 GPCI
Malpractice0.65
0.65 RVUs× 1.000 GPCI
Adjusted RVUs
3.7000
Conversion factor
$33.4009
Medicare rate
$123.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 36861
The CMS indicators that decide how 36861 is paid alongside other services.
CMS payment indicators · 36861
Cannula declotting
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
36861 without 51 · national facility
$123.58
Cannula declotting
36861-51 · Second procedure: 50%
$61.79
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%).
36861 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 36860Cannula declotting
- Choose 36860 for declotting an external arteriovenous cannula; 36861 describes an internal cannula.
- 36831Fistula thrombectomy
- 36831 describes open thrombectomy of an arteriovenous fistula. Use 36861 when the documented treatment is directed at the internal cannula.
- 36904Dialysis thrombectomy
- 36904 describes percutaneous transluminal thrombectomy of a dialysis circuit. This code describes declotting an internal cannula, not an endovascular circuit thrombectomy.
36861 billing questions
How is this different from 36860?
This code describes declotting an internal arteriovenous cannula. Code 36860 is for an external cannula.
When would 36831 be more appropriate?
Use 36831 for open thrombectomy of an arteriovenous fistula. This code is for clot removal directed at the internal cannula.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
What documentation supports reporting this code?
Document that the cannula is internal, that clot obstructed it, and that the service involved removal of that clot. Distinguish cannula declotting from open fistula thrombectomy.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Same-day preoperative and postoperative care is included in this code's 0-day global period.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service. Co-surgeons and team surgery are 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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