CPT 0876T: Fistula Maturation Duplex Scan

CPT code 0876T denotes a computer–aided duplex ultrasound scan limited to the body of an arteriovenous fistula to assess maturation by measuring volume flow, diameter, and depth. This targeted vascular imaging code matters nationally as it supports clinical decision-making for dialysis access management and documents objective maturation parameters that can affect subsequent interventions or timing of access use. The analysis covers national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.

Readers will find a concise overview of how this service is defined and where it is typically performed, plus benchmarking context and payer coverage patterns where available. The publication outlines common billing considerations, relevant clinical context about fistula maturation assessment, and a summary of typical sites of service. Data limitations are noted where input fields are unavailable. This resource is intended to inform revenue cycle, coding, and clinical teams about the purpose and typical use of CPT code 0876T in national practice settings.

Billing Code Overview

CPT code 0876T describes a computer–aided duplex scan of only the body of the fistula to assess signs of maturation, including measurements of volume flow, diameter, and depth. This service evaluates arteriovenous fistula maturation status after creation to inform vascular access planning.

Service type: Diagnostic vascular ultrasound focused on fistula maturation
Typical site of service: Outpatient vascular lab or hospital outpatient imaging suite

Clinical Context

A 62-year-old patient with end-stage renal disease has a recently created autogenous arteriovenous fistula in the forearm. At 4–6 weeks post-creation the vascular access team schedules a noninvasive ultrasound assessment to determine fistula maturation prior to initial cannulation for hemodialysis. The provider performs a computer‑aided duplex scan limited to the body of the fistula to measure volume flow, vessel diameter, and depth beneath the skin. The clinical workflow includes patient consent, review of surgical history and prior imaging, acquisition of duplex images and flow calculations using the device’s software, interpretation of results by the ordering vascular specialist or radiologist, and documentation of measurements and recommendations in the chart. Results guide decisions about timing of first use, need for interventions (angioplasty, banding, or revision), or continued surveillance.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	When work required is substantially greater than usual for this ultrasound scan (documentation required).
`26`	Professional component	When billing only the physician interpretation/report for the duplex study separated from technical component.

Taxonomy Code	Specialty	Notes
207RH0000X	Vascular Surgery	Commonly performs access creation and post‑op ultrasound assessment.
2084P0800X	Interventional Cardiology	Performs vascular access assessments and endovascular interventions.
2086S0201X	Diagnostic Radiology	Interprets and reports vascular ultrasound studies.
363A00000X	Nephrology	Orders and uses maturation results to time cannulation for dialysis.
354E00000X	Physician Assistant	May perform or assist in acquisition under physician supervision.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I77.3`	Arteriovenous fistula, acquired	Direct indication for duplex assessment of fistula maturation and flow.
`N18.6`	End stage renal disease	Underlying condition necessitating creation and maturation assessment of hemodialysis access.
`I83.019`	Varicose veins of right lower extremity with pain	Not directly typical for fistula assessment; Data not available in the input.
`I97.2`	Postprocedural complications and disorders of circulatory system, not elsewhere classified	Used when complications of access creation require imaging evaluation.
`Z99.2`	Encounter for dialysis and dialysis dependence	Administrative code associated with patients receiving dialysis; relevant to timing and use decisions.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93975`	Duplex scan of extremity arteries or arterial bypass grafts; complete study	A broader duplex arterial study sometimes performed if arterial inflow or outflow evaluation of the limb is needed in conjunction with fistula assessment.
`93976`	Duplex scan of extremity arteries or arterial bypass grafts; limited study	Used when a targeted/limited arterial evaluation is performed alongside the fistula body scan.
`36147`	Introduction of needle into hemodialysis access with injection of contrast for diagnostic angiography, radiological supervision and interpretation	Performed when duplex shows stenosis requiring diagnostic fistulogram prior to intervention.
`35476`	Transcatheter therapy, vascular, open or percutaneous, for dialysis access (e.g., balloon angioplasty)	Performed when the duplex demonstrates inadequate maturation or hemodynamically significant stenosis requiring endovascular treatment.
`93990`	Duplex scan of extracranial arteries; limited or follow-up study	May be used in vascular labs for follow-up or focused Doppler assessments when standard peripheral codes are not applicable.

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Summary & Overview