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CPT 36810: External Scribner-Type Cannulation for Hemodialysis

CPT code 36810 denotes an external Scribner–type cannulation procedure to establish temporary arteriovenous access for hemodialysis. This vascular access technique remains a key procedural option for patients needing immediate dialysis support and is relevant across hospitals, ambulatory surgical centers, and dialysis facilities. Nationally, accurate coding of this procedure supports appropriate tracking of dialysis care delivery, resource use, and quality measurement.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for CPT code 36810, standard sites of service, and common billing considerations. The publication summarizes national benchmarks where available, highlights notable policy and coverage updates that affect reimbursement and prior authorization, and places the procedure in clinical workflow for teams managing acute and chronic renal failure care.

This overview is intended for clinicians, billing professionals, and policy analysts seeking a clear, actionable summary of what CPT code 36810 represents, why it matters for dialysis access management, and which payers commonly cover the service. Data not available in the input is noted as such in relevant sections.

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Billing Code Overview

CPT code 36810 describes an external Scribner–type cannulation procedure in which a provider inserts one end of a cannula into a vein and the other end into an artery to create vascular access for hemodialysis. The procedure enables a dialysis machine to remove waste, salt, and excess fluid from the blood and return purified blood to the patient.

Service Type: Vascular access procedure for hemodialysis

Typical Site of Service: Outpatient vascular procedure area, dialysis center, or ambulatory surgery setting

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CPT 36810: External Scribner-Type Cannulation for Hemodialysis

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Billing Code Overview

Service Type: Vascular access procedure for hemodialysis

Typical Site of Service: Outpatient vascular procedure area, dialysis center, or ambulatory surgery setting

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with end-stage renal disease (ESRD) requiring chronic hemodialysis presents for creation of an external Scribner-type arteriovenous shunt (external cannulation connecting a vein to an artery). The procedure is scheduled in an outpatient vascular access procedure room or ambulatory surgery center under local anesthesia and conscious sedation. Pre-procedure workflow includes vascular mapping, consent, assessment of infection risk, and review of anticoagulation. The provider identifies suitable vessels, creates the external cannulation with the cannula tunneled and secured, confirms flow and hemostasis, and provides post-procedure instructions including exit-site care and dialysis scheduling. Typical sites of service are hospital outpatient department, ambulatory surgery center, or freestanding dialysis access center. The patient typically returns to the dialysis unit for first use after assessment for adequate flow and absence of bleeding or infection; follow-up includes access surveillance and wound checks.

Coding Specifications

Modifier	Description	When to Use
`11`	Primary Procedure	When this `36810` is the principal service performed during the encounter
`22`	Increased Procedural Services	When the procedure requires substantially more effort or time than usual due to complexity
`23`	Unusual Anesthesia	When general anesthesia is required for medically necessary reasons
`26`	Professional Component	If reporting only the physician professional component separate from technical resources (rare for surgical vascular access)
`52`	Reduced Services	When the procedure is attempted but not completed or only partially performed
`53`	Discontinued Procedure	When the procedure is started but terminated due to extenuating circumstances
`62`	Concurrent Surgeon	When another surgeon performs a distinct portion of the procedure concurrently
`66`	Surgical Team (Two or More Surgeons)	When a surgical team approach is documented for a complex access creation
`78`	Unplanned Return to the OR Following Initial Procedure	For a return trip to the operating room for a complication related to the original `36810` within the payer-defined timeframe
`79`	Unrelated Procedure or Service by the Same Physician During the Postoperative Period	Use if an unrelated procedure is performed during the global period (note: `79` is not in the provided list; therefore it is not included)
`50`	Bilateral Procedure	When bilateral vascular access creation is performed during the same session (rare for peripheral AV access)
`52`	Reduced Services	(Duplicate entry avoided in practice)
`73`	Discontinued Outpatient Procedure Prior to Anesthesia	When the outpatient procedure is discontinued before anesthesia is administered
`76`	Repeat Procedure by Same Physician	When the same physician performs a repeat procedure later the same day (not common for `36810`)

Taxonomy Code	Specialty	Notes
208000000X	Vascular Surgery	Common specialty performing arteriovenous access creation and revisions
2086S0123X	Interventional Nephrology	Common specialty performing dialysis access creation and management in some centers
207VG0400X	General Surgery	Performs vascular access procedures in hospital settings
207L00000X	Thoracic Surgery	May perform complex central access or shunt procedures in select cases
208000000X	Plastic and Reconstructive Surgery	Occasionally involved for complex soft tissue coverage or graft tunneling

Note: Only the most clinically relevant modifiers from the provided list are shown with typical usage; taxonomy entries list the most common provider specialties that perform this procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I12.0`	Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease	Hypertension is a common cause of ESRD necessitating hemodialysis access such as `36810`
`N18.6`	End stage renal disease	Primary indication for creation of vascular access for chronic hemodialysis
`N18.5`	Chronic kidney disease, stage 5	Patients with Stage 5 CKD frequently require permanent or temporary dialysis access
`Z99.2`	Dependence on renal dialysis	Describes patients dependent on dialysis who require functioning vascular access
`T82.8XXA`	Other complications of prosthetic devices, implants and grafts, initial encounter	Relevant when external cannulation is performed due to complications of existing access devices
`I95.1`	Orthostatic hypotension	Hemodynamic considerations may affect access creation and peri-procedural monitoring
`A41.9`	Sepsis, unspecified organism	Active systemic infection is a contraindication or a cause for access revision; infection surveillance is critical
`L03.90`	Cellulitis, unspecified	Local infection at access site impacts timing and type of access creation or revision

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36818`	Thrombectomy, open; for dialysis access (e.g., clot removal from AV graft or fistula)	Performed when an existing dialysis access develops thrombosis, may be performed after or instead of creating new external access
`36830`	Revision, thrombectomy, and repair of arteriovenous fistula, open; with thrombectomy	Used for revision of a failing AV fistula which may be part of the access management pathway surrounding `36810`
`36901`	Endovascular repair or thrombectomy of dialysis access, open or percutaneous, with or without infusion	Endovascular alternatives or adjuncts to open external cannulation for dialysis access management
`36415`	Collection of venous blood by venipuncture	Routine pre-procedure labs (e.g., coagulation studies) often performed before `36810`
`99213`	Office or other outpatient visit, established patient, low to moderate complexity	Typical pre- or post-procedure evaluation visit for dialysis access creation and follow-up

CPT 36800: Insertion of Cannulae into Two Veins for Hemodialysis

CPT-36815-HEMODIALYSIS-CANNULA-REPOSITIONING-OR-REMOVAL

CPT 36815: Hemodialysis Cannula Repositioning or Removal

CPT-36818-CEPHALIC-TO-BRACHIAL-ARTERIOVENOUS-ANASTOMOSIS-UPPER-ARM

CPT 36818: Cephalic-to-Brachial Arteriovenous Anastomosis for Hemodialysis

CPT-36819-BASILIC-TO-BRACHIAL-AV-FISTULA-CREATION-UPPER-ARM

CPT 36819: Basilic-to-Brachial AV Fistula Creation for Hemodialysis

CPT-36820-ARTERIOVENOUS-ANASTOMOSIS-FOREARM-FISTULA-CREATION

CPT 36820: Arteriovenous Anastomosis (Forearm) for Hemodialysis

CPT-36821-ARTERIOVENOUS-ANASTOMOSIS-FOR-HEMODIALYSIS-ACCESS

CPT 36821: Arteriovenous Anastomosis for Hemodialysis Vascular Access

CPT-36823-ISOLATED-EXTRACORPOREAL-REGIONAL-CHEMOTHERAPY-PERFUSION-EXTREMITY

CPT 36823: Isolated Extracorporeal Regional Chemotherapy Perfusion, Extremity

CPT-36825-ARTERIOVENOUS-FISTULA-AUTOGENOUS-VEIN-GRAFT

CPT 36825: Arteriovenous Fistula with Autogenous Vein Graft

CPT-36830-ARTERIOVENOUS-FISTULA-NONAUTOGENOUS-GRAFT-HEMODIALYSIS-ACCESS

CPT 36830: Arteriovenous Fistula with Nonautogenous Graft for Hemodialysis

CPT-36831-ARTERIOVENOUS-FISTULA-THROMBECTOMY

CPT 36831: Arteriovenous Fistula Thrombectomy

Showing 1–10 of 18

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`11`	Primary Procedure	When this `36810` is the principal service performed during the encounter
`22`	Increased Procedural Services	When the procedure requires substantially more effort or time than usual due to complexity
`23`	Unusual Anesthesia	When general anesthesia is required for medically necessary reasons
`26`	Professional Component	If reporting only the physician professional component separate from technical resources (rare for surgical vascular access)
`52`	Reduced Services	When the procedure is attempted but not completed or only partially performed
`53`	Discontinued Procedure	When the procedure is started but terminated due to extenuating circumstances
`62`	Concurrent Surgeon	When another surgeon performs a distinct portion of the procedure concurrently
`66`	Surgical Team (Two or More Surgeons)	When a surgical team approach is documented for a complex access creation
`78`	Unplanned Return to the OR Following Initial Procedure	For a return trip to the operating room for a complication related to the original `36810` within the payer-defined timeframe
`79`	Unrelated Procedure or Service by the Same Physician During the Postoperative Period	Use if an unrelated procedure is performed during the global period (note: `79` is not in the provided list; therefore it is not included)
`50`	Bilateral Procedure	When bilateral vascular access creation is performed during the same session (rare for peripheral AV access)
`52`	Reduced Services	(Duplicate entry avoided in practice)
`73`	Discontinued Outpatient Procedure Prior to Anesthesia	When the outpatient procedure is discontinued before anesthesia is administered
`76`	Repeat Procedure by Same Physician	When the same physician performs a repeat procedure later the same day (not common for `36810`)

Taxonomy Code	Specialty	Notes
208000000X	Vascular Surgery	Common specialty performing arteriovenous access creation and revisions
2086S0123X	Interventional Nephrology	Common specialty performing dialysis access creation and management in some centers
207VG0400X	General Surgery	Performs vascular access procedures in hospital settings
207L00000X	Thoracic Surgery	May perform complex central access or shunt procedures in select cases
208000000X	Plastic and Reconstructive Surgery	Occasionally involved for complex soft tissue coverage or graft tunneling

Note: Only the most clinically relevant modifiers from the provided list are shown with typical usage; taxonomy entries list the most common provider specialties that perform this procedure.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I12.0`	Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease	Hypertension is a common cause of ESRD necessitating hemodialysis access such as `36810`
`N18.6`	End stage renal disease	Primary indication for creation of vascular access for chronic hemodialysis
`N18.5`	Chronic kidney disease, stage 5	Patients with Stage 5 CKD frequently require permanent or temporary dialysis access
`Z99.2`	Dependence on renal dialysis	Describes patients dependent on dialysis who require functioning vascular access
`T82.8XXA`	Other complications of prosthetic devices, implants and grafts, initial encounter	Relevant when external cannulation is performed due to complications of existing access devices
`I95.1`	Orthostatic hypotension	Hemodynamic considerations may affect access creation and peri-procedural monitoring
`A41.9`	Sepsis, unspecified organism	Active systemic infection is a contraindication or a cause for access revision; infection surveillance is critical
`L03.90`	Cellulitis, unspecified	Local infection at access site impacts timing and type of access creation or revision

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36818`	Thrombectomy, open; for dialysis access (e.g., clot removal from AV graft or fistula)	Performed when an existing dialysis access develops thrombosis, may be performed after or instead of creating new external access
`36830`	Revision, thrombectomy, and repair of arteriovenous fistula, open; with thrombectomy	Used for revision of a failing AV fistula which may be part of the access management pathway surrounding `36810`
`36901`	Endovascular repair or thrombectomy of dialysis access, open or percutaneous, with or without infusion	Endovascular alternatives or adjuncts to open external cannulation for dialysis access management
`36415`	Collection of venous blood by venipuncture	Routine pre-procedure labs (e.g., coagulation studies) often performed before `36810`
`99213`	Office or other outpatient visit, established patient, low to moderate complexity	Typical pre- or post-procedure evaluation visit for dialysis access creation and follow-up

CPT 36800: Insertion of Cannulae into Two Veins for Hemodialysis

CPT-36815-HEMODIALYSIS-CANNULA-REPOSITIONING-OR-REMOVAL

CPT 36815: Hemodialysis Cannula Repositioning or Removal

CPT-36818-CEPHALIC-TO-BRACHIAL-ARTERIOVENOUS-ANASTOMOSIS-UPPER-ARM

CPT 36818: Cephalic-to-Brachial Arteriovenous Anastomosis for Hemodialysis

CPT-36819-BASILIC-TO-BRACHIAL-AV-FISTULA-CREATION-UPPER-ARM

CPT 36819: Basilic-to-Brachial AV Fistula Creation for Hemodialysis

CPT-36820-ARTERIOVENOUS-ANASTOMOSIS-FOREARM-FISTULA-CREATION

CPT 36820: Arteriovenous Anastomosis (Forearm) for Hemodialysis

CPT-36821-ARTERIOVENOUS-ANASTOMOSIS-FOR-HEMODIALYSIS-ACCESS

CPT 36821: Arteriovenous Anastomosis for Hemodialysis Vascular Access

CPT-36823-ISOLATED-EXTRACORPOREAL-REGIONAL-CHEMOTHERAPY-PERFUSION-EXTREMITY

CPT 36823: Isolated Extracorporeal Regional Chemotherapy Perfusion, Extremity

CPT-36825-ARTERIOVENOUS-FISTULA-AUTOGENOUS-VEIN-GRAFT

CPT 36825: Arteriovenous Fistula with Autogenous Vein Graft

CPT-36830-ARTERIOVENOUS-FISTULA-NONAUTOGENOUS-GRAFT-HEMODIALYSIS-ACCESS

CPT 36830: Arteriovenous Fistula with Nonautogenous Graft for Hemodialysis

CPT-36831-ARTERIOVENOUS-FISTULA-THROMBECTOMY

CPT 36831: Arteriovenous Fistula Thrombectomy

Showing 1–10 of 18

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 36810: External Scribner-Type Cannulation for Hemodialysis

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Billing Code Overview

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CPT 36810: External Scribner-Type Cannulation for Hemodialysis

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References