Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesHemodialysis Access, Intervascular Cannulation for Extracorporeal Circulation, or Shunt Insertion Procedures on Arteries and VeinsCPT cpt-36823-isolated-extracorporeal-regional-chemotherapy-perfusion-extremity
    Ask Trek AI about this page

    CPT 36823: Isolated Limb Perfusion with Extracorporeal Circulation

    Medicare pays $1326 on average nationally for this procedure.

    CPT code 36823 describes the insertion of one or more cannulas into an artery and vein to establish isolated extracorporeal circulation for regional heated or nonheated chemotherapy perfusion to an extremity; service type: isolated limb perfusion with extracorporeal circulation, typical site of service: operating room or interventional suite in an inpatient or outpatient hospital setting.

    For related coverage guidance, see recent payer policy updates: Vafseo (vadadustat) for anemia in CKD on dialysis, Metabolic Disorders - Cysteamine (Oral) Products for Individual and Family Plans, Kerendia (finerenone) — Coverage Criteria.

    Customize your policy alerts

    Sign up for cpt 36823 policy alerts

    Get alerted when payer policies referencing 36823 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 6

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient with locally advanced extremity soft tissue sarcoma or recurrent melanoma confined to the limb is scheduled for isolated limb perfusion (ILP) with regional chemotherapy. The multidisciplinary workflow begins with preoperative oncology evaluation and imaging to confirm limb-confined disease and vascular access planning. In the operating room or interventional suite, the vascular surgeon or surgical oncologist inserts arterial and venous cannulas into the limb’s major artery and vein under fluoroscopic and ultrasound guidance. An extracorporeal circuit with a pump and heat exchanger is connected to the cannulas to establish isolated extracorporeal circulation of the limb; limb tourniquet or vascular clamps are applied proximally to prevent systemic exposure. Heated or nonheated regional chemotherapeutic agents (for example, melphalan ± tumor necrosis factor in select centers) are circulated through the isolated limb for a defined perfusion time, then the limb is flushed and circulation is restored. Typical perioperative team members include surgical oncology, vascular surgery, anesthesia, perfusionist, and oncology nursing. Post-procedure monitoring focuses on limb perfusion, compartment pressures, local toxicity, and systemic leak surveillance before discharge to inpatient recovery or monitored outpatient care. The typical site of service is an operating room or interventional radiology suite within a hospital with perfusion and oncology support.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36011Introduction of a catheter, superior vena cava, central venous access for infusion (non-tunneled)May be used for central venous access for systemic monitoring or administration during ILP if separate central lines are placed.
    36556Cannulation of central vein for hemodialysis (tunneled)Occasionally performed if tunneled vascular access is needed for prolonged perioperative care (rarely directly related).
    36600Arterial catheterization or cannulation for diagnostic or monitoring purposesUsed when arterial line placement is performed for invasive hemodynamic monitoring during perfusion.
    37799Unlisted procedure, vascular surgeryUsed for additional vascular procedures not described by specific CPT codes performed during limb perfusion.
    96549Chemotherapy administration into an extracorporeal circuit (unlisted within CPT range — provider must verify)Represents the chemotherapy administration component of the isolated limb perfusion; local coding guidance may vary, and documentation must link perfusion and drug administration.
    92310Therapeutic, prophylactic, or diagnostic injection (code example for adjunct limb injections)May be used for local adjunct procedures but coding depends on exact service rendered.

    Note: If payer-specific bundling or local coding guidelines apply, check individual carrier policies for Blue Cross Blue Shield, Aetna, Cigna Health, UnitedHealthcare, BUCA, and Medicare regarding bundling of perfusion, cannulation, anesthesia, and chemotherapeutic agent administration.

    Related Modifiers

    13 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    51Modifier –51 (Multiple Procedures) is used when the same provider performs multiple procedures in the same session to identify secondary, non‑exempt procedures and indicate payment reduction logic…- Use modifier -51 when the same provider performs multiple distinct procedures during the same patient encounter: report the highest‑valued procedure first (no modifier) and append -51 to…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Showing 1–10 of 13

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208800000X
    207L00000X
    174400000X
    207K00000X
    261QF0050X
    261QM1103X
    207RP1002X
    246QH0000X

    Related Payer Policy Updates

    Specialty: Nephrology1 / 3

    10 rows

    PolicyPayerEffective Date
    Vafseo (vadadustat) for anemia in CKD on dialysisCigna2026-08-15
    Metabolic Disorders - Cysteamine (Oral) Products for Individual and Family PlansCigna2026-08-15
    Kerendia (finerenone) — Coverage CriteriaBlue Cross Blue Shield - Iowa2026-08-05
    Voyxact (sibeprenlimab-szsl) — Prior authorization / medical necessity for primary IgA nephropathyColorado Rocky Mountain Health Plans2026-08-01
    Oxlumo (lumasiran) and Rivfloza (nedosiran) — Coverage Criteria (Ohio)Colorado Rocky Mountain Health Plans2026-08-01
    Korsuva (difelikefalin) — Medical Benefit Drug Coverage Criteria (Ohio)Colorado Rocky Mountain Health Plans2026-08-01
    Complement Inhibitors - EmpaveliCigna2026-08-01
    Tolvaptan (Jynarque)Cigna2026-08-01
    Nephrology - Filspari (sparsentan) coverageCigna2026-08-01
    Rivfloza (nedosiran) prior authorization for PH1UnitedHealthcare2026-08-01

    Related Codes

    CPT-36800-HEMODIALYSIS-CANNULA-INSERTION-TWO-VEINS

    CPT 36800: Insertion of Cannulae for Hemodialysis, Two Veins

    CPT-36810-HEMODIALYSIS-SCRIBNER-TYPE-CANNULATION

    CPT 36810: Scribner-Type Arteriovenous Cannulation for Hemodialysis

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

    CPT 36815: Reposition or Removal of Hemodialysis Cannula

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

    CPT 36818: Cephalic Vein to Brachial Artery Arteriovenous Anastomosis

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

    CPT 36819: Basilic Vein to Brachial Artery Arteriovenous Anastomosis

    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 Creation for Hemodialysis Access

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

    CPT 36825: Creation of Arteriovenous Fistula with Autogenous Vein Graft

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

    CPT 36830: Arteriovenous Fistula with Nonautogenous Graft

    CPT-36831-ARTERIOVENOUS-FISTULA-THROMBECTOMY

    CPT 36831: Open Thrombectomy of Arteriovenous Fistula

    Showing 1–10 of 18

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    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.