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    OpenPayerBilling CodesHemodialysis Access, Intervascular Cannulation for Extracorporeal Circulation, or Shunt Insertion Procedures on Arteries and VeinsCPT cpt-36831-arteriovenous-fistula-thrombectomy
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    CPT 36831: Open Thrombectomy of Arteriovenous Fistula

    Medicare pays $568 on average nationally for this procedure.

    CPT code 36831 describes an open surgical thrombectomy of an arteriovenous fistula in which the provider surgically opens an autogenous or nonautogenous AV fistula and removes the clot from the artery-to-vein connection without revising the fistula; service type: open surgical thrombectomy for dialysis access; typical site of service: operating room or procedure suite in a hospital or ambulatory surgical center, commonly performed on the upper arm or forearm AV fistula used for hemodialysis.

    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.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with end-stage renal disease on maintenance hemodialysis presents to the vascular surgery service with sudden loss of thrill and inability to use the left radiocephalic arteriovenous fistula for dialysis. Physical exam and duplex ultrasound confirm an acute thrombosis confined to the native fistula without evidence of aneurysmal degeneration or anastomotic failure. The patient is taken to the operating room for surgical thrombectomy of the arteriovenous fistula. Under regional or general anesthesia, the vascular surgeon exposes the fistula, surgically opens the venous segment at or near the anastomosis, and removes thrombus using simple clot extraction techniques and limited irrigation. No revision of the fistula anastomosis or interposition grafting is performed during the same encounter. Hemostasis is achieved and the incision is closed. The patient is monitored in a post-anesthesia care area and returned to the dialysis schedule once patency is confirmed by clinical exam and/or duplex study.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    36832Thrombectomy, autogenous arteriovenous fistula, with revision of the fistula (surgical)Performed when thrombectomy requires surgical revision of the fistula or anastomosis; distinct from 36831 because revision is included.
    36901Introduction of catheter, dialysis circuit, other; initial placementMay be performed if temporary central venous dialysis access is needed perioperatively when the fistula is not usable.
    36011Introduction of catheter; cannulation of artery for diagnostic purposes (e.g., arterial line)May be performed for perioperative arterial monitoring in selected patients during surgery.
    93970Duplex scan of dialysis access (segmental/complete)Used pre- or post-procedure to assess fistula patency and detect residual thrombus or stenosis.
    99223Initial hospital care, typically 70 minutes or moreRepresents higher-level initial inpatient evaluation when the patient requires complex preoperative evaluation or admission related to the procedure.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    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…
    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…
    79Modifier 79 indicates a surgical procedure performed during the postoperative global period of a prior surgery that is unrelated to the original procedure. Per AMA/CPT and CMS guidance, it is…- Use modifier 79 when the same physician (or same‑specialty physician in the same group) performs a surgical procedure during the postoperative global period of a prior surgery and the new procedure…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2251S0007X
    225CA2500X
    171WV0202X
    1835E0208X
    163WS0121X
    261QX0203X
    207SG0203X
    207RM1200X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    I63.9Cerebral infarction, unspecified
    I66.9Occlusion and stenosis of unspecified cerebral artery
    I73.9Peripheral vascular disease, unspecified
    I74.3Embolism and thrombosis of arteries of the lower extremities
    I77.1Stricture of artery
    I80.3Phlebitis and thrombophlebitis of lower extremities, unspecified
    I80.9Phlebitis and thrombophlebitis of unspecified site
    I82.401Acute embolism and thrombosis of unspecified deep veins of right lower extremity
    I82.402Acute embolism and thrombosis of unspecified deep veins of left lower extremity
    I82.403Acute embolism and thrombosis of unspecified deep veins of lower extremity, bilateral

    Showing 1–10 of 25

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

    CPT 36823: Isolated Limb Perfusion with Extracorporeal Circulation

    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

    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.
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