Summary & Overview
CPT 36833: Arteriovenous Fistula Revision with Thrombectomy
CPT code 36833 denotes a surgical arteriovenous fistula (AVF) revision with thrombectomy — a procedure that reopens and revises the artery-to-vein connection used for hemodialysis while removing an obstructing thrombus. Nationally, this code is important for dialysis access maintenance, affecting outpatient surgical services, vascular surgery workflows, and dialysis program capacity. It is commonly billed when patients present with AVF thrombosis or access dysfunction requiring operative repair.
Key payers covered in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise clinical and billing overview of CPT code 36833, including the primary service type, typical site of service, and why the procedure matters for dialysis-dependent populations. The publication also summarizes common billing practices and benchmarking context where available and highlights the clinical circumstances that prompt use of this code. Where input data is missing, the report notes that specific details are not available in the input.
Billing Code Overview
CPT code 36833 describes a surgical procedure to open and revise an arteriovenous fistula, including removal of thrombus (thrombectomy) and revision of the artery-to-vein connection. An arteriovenous fistula is a surgically created connection between an artery and a vein, most commonly in the forearm or upper arm, used to provide reliable vascular access for hemodialysis.
Service Type: Surgical vascular revision with thrombectomy
Typical Site of Service: Operating room or ambulatory surgical center, commonly performed in hospital outpatient settings or same-day surgery centers where vascular surgery for dialysis access is provided.
Data not available in the input for additional fields such as associated taxonomies, ICD-10 diagnoses, or related codes.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with end-stage renal disease on maintenance hemodialysis via a left forearm autogenous arteriovenous fistula presents with sudden loss of thrill and poor dialysis flows. Duplex ultrasound confirms acute thrombosis of the fistula with a narrowed venous anastomosis. The vascular surgeon schedules an operative revision of the fistula, performs surgical exploration and revision of the arteriovenous anastomosis, and obtains a thrombectomy to remove the intraluminal clot to restore flow. The procedure is performed in an operating room setting with conscious sedation or general anesthesia, perioperative anticoagulation management, and intraoperative assessment of thrill and flow. Postoperative workflow includes vascular access monitoring, wound care instructions, and coordination with the patient’s dialysis center for early use and flow reassessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased Procedural Services | Use when the work, time, or technical difficulty substantially exceeds typical for 36833. Documentation must justify increased effort. |
26 |